Percent Predicted Value for the 6-Minute Walk Test: Using Norm-Referenced Equations to Characterize Severity in Persons With CHF

Balashov, Konstantin; Feldman, Debbie Ehrmann; Savard, Sylvie; Houde, Stéfanie; Frenette, Marc; Ducharme, Anique; Giannetti, Nadia; Michel, Caroline; Pilote, Louise

doi:10.1016/j.cardfail.2007.09.005

Cited by 24 publications

(25 citation statements)

References 30 publications

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“…It is inexpensive, reproducible, objective, and simple to use and has been shown to be an adequate alternative to cardiopulmonary testing. [12][13][14] New York Heart Association (NYHA) functional class stratifies patients into 1 of 4 categories based on physical limitations and shortness of breath. It is a clinicianrated variable that does not necessarily reflect patient perceptions.…”

Section: Quality Of Lifementioning

confidence: 99%

“…Studies comparing NYHA classification and the 6-minute walk test have found a significant correlation, suggesting that NYHA class is an accurate surrogate for physical functioning. 13,14 Visual analog rating scales are 100-mm vertical or horizontal lines that measure a patient's overall perception of their QOL. The lines have anchor points of 0 (extremely poor QOL) and 100 (excellent QOL).…”

Section: Quality Of Lifementioning

confidence: 99%

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Quality of Life and Left Ventricular Assist Device Support

2012

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M ore than 5 million Americans are living with heart failure, with an additional 500 000 cases diagnosed each year. 1 Ongoing improvements in patient management will only increase the number of patients surviving to develop severe refractory heart failure (stage D). Approximately 5% to 10% of all heart failure patients are classified as stage D and defined as patients who continue to have symptoms of dyspnea or fatigue at rest despite optimal medical management. 2 Mechanical circulatory support (MCS) is an advanced surgical therapy for the treatment of stage D heart failure. 2 Last year, Ͼ1500 patients in the United States were implanted with a left ventricular assist device (LVAD), an implantable system that supports the failing left ventricle. 3 Implantation of an LVAD is an effective strategy to prolong survival and to improve the quality of life (QOL) of patients living with stage D heart failure. The indications for LVAD support include bridge to recovery (BTR), bridge to transplantation (BTT), or destination therapy (DT). The purpose of this article is to discuss QOL for patients supported on an LVAD. The discussion begins with an overview of QOL and how it is measured, followed by an in-depth review of QOL results in patients supported on an LVAD.

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Section: Quality Of Lifementioning

confidence: 99%

Section: Quality Of Lifementioning

confidence: 99%

Quality of Life and Left Ventricular Assist Device Support

2012

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“…1 Its precise quantification is of value for studying pathogenetic mechanisms involved in functional limitation and for objectively staging the clinical severity of HF. 1 Basically, 2 methods for defining the extent of exercise limitation, the 6-minute walk test (6MWT) 2,3 and the cardiopulmonary exercise testing (CPET), 4 are currently used in daily clinical practice. The 2 testing modalities are consistently different.…”

mentioning

confidence: 99%

Six-Minute Walk Test and Cardiopulmonary Exercise Testing in Patients With Chronic Heart Failure

Guazzi

Dickstein

Vicenzi

et al. 2009

Circ: Heart Failure

176

132

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Background-The six-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) are the 2 testing modalities most broadly used for assessing functional limitation in patients with heart failure (HF). A comprehensive comparison on clinical and prognostic validity of the 2 techniques has not been performed and is the aim of the present investigation. Methods and Results-Two hundred fifty-three patients diagnosed with systolic (nϭ211) or diastolic (nϭ42) HF (age:61.9Ϯ10.1 years; New York Heart Association Class: 2.2Ϯ0.78) underwent a 6MWT and a symptom-limited CPET evaluation and were prospectively followed up. During the 4-year tracking period, there were 43 cardiac-related deaths with an annual cardiac mortality rate of 8.7%. The 6MWT distance correlated with CPET-derived variables (ie, peak VO 2 , VO 2 at anaerobic threshold, and VE/VCO 2 slope) and was significantly reduced in proportion with lower peak VO 2 and higher VE/VCO 2 slope classes and presence of an exercise oscillatory breathing (EOB) pattern (PϽ0.01). However, no significant differences were observed in distance covered between survivors and nonsurvivors (353.2Ϯ95.8 m versus 338.5Ϯ76.4 m; PϭNS). At univariate and multivariate Cox proportional analyses, the association of the 6MWT distance with survival was not significant either as a continuous or dicotomized variable (Յ300 m). Conversely, CPET-derived variables emerged as prognostic with the strongest association found for EOB (systolic HF) and VE/VCO 2 slope (entire population with HF and patients with a 6MWTՅ300 m). Conclusions-The 6MWT is confirmed to be a simple and reliable first-line test for quantification of exercise intolerance in patients with HF. However, there is no supportive evidence for its use as a prognostic marker in alternative to or in conjunction with CPET-derived variables. (Circ Heart Fail. 2009;2:549-555.)

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“…The use of 6MWD %pred versus 6MWD in meters in idiopathic pulmonary fibrosis [40,41], chronic lung diseases [42] and congestive heart failure [43] better reflects patients' clinical status. In PAH, despite the long-standing use of 6MWD, it is largely unknown whether the %pred is a better marker of disease severity than 6MWD in meters; Lee et al [13 ]showed that %pred was not better for predicting mortality.…”

Section: Discussionmentioning

confidence: 99%

Early Decline in Six-Minute Walk Distance from the Time of Diagnosis Predicts Clinical Worsening in Pulmonary Arterial Hypertension

Huang

Mehta²,

Mura

2015

Respiration

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Background: The six-minute walk distance (6MWD) is commonly used to assess pulmonary arterial hypertension (PAH). However, the role of 6MWD in predicting outcomes in PAH is controversial. Clinical worsening is being increasingly considered as a clinically meaningful end point in PAH. Objectives: We aimed to investigate whether early longitudinal changes in 6MWD (Δ6MWD) in meters and percent predicted (%pred) from the time of diagnosis predict clinical worsening of PAH. Methods: One hundred patients with group I PAH were retrospectively assessed. 6MWD was calculated using American (%pred US) or Canadian (%pred CAN) reference equations. Δ6MWD at 6 months were recorded. Clinical worsening was defined as either: development of right heart failure, hospital admission for PAH, referral for lung transplantation or initiation of prostanoids after oral therapy failed. Optimal 6-month differences in 6MWD to detect worsening were defined with receiver operating characteristics (ROC) analysis. Results: Progressors, i.e. patients with clinical worsening, and nonprogressors showed significant differences in Δ6MWD. The most clinically significant declines in 6MWD at 6 months were ≥35 m, ≥8%pred US and ≥6%pred CAN. ROC and Cox proportional hazard analyses showed equivalent results for 6MWD %pred and meters. Six-month declines in 6MWD predicted worsening with a high specificity (94%) but a low sensitivity (33%). Conclusions: Early declines in 6MWD (within the first 6 months) predict future clinical worsening of PAH with high specificity. Δ6MWD may still be part of a comprehensive assessment of a patient's clinical status. However, given the poor sensitivity, a decline in 6MWD should be used with other clinical tools to make an appropriate assessment of the progression of PAH.

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Percent Predicted Value for the 6-Minute Walk Test: Using Norm-Referenced Equations to Characterize Severity in Persons With CHF

Cited by 24 publications

References 30 publications

Quality of Life and Left Ventricular Assist Device Support

Quality of Life and Left Ventricular Assist Device Support

Six-Minute Walk Test and Cardiopulmonary Exercise Testing in Patients With Chronic Heart Failure

Early Decline in Six-Minute Walk Distance from the Time of Diagnosis Predicts Clinical Worsening in Pulmonary Arterial Hypertension

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