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The association of 6-minute walk performance and outcomes in stable outpatients with heart failure

Jeptha P Curtis1, Saif S Rathore, Yongfei Wang

  • 1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8088, USA.

Journal of Cardiac Failure
|February 18, 2004
PubMed

Insights

The 6-minute walk test is a valuable tool for predicting mortality risk in heart failure patients. Walking less than 200 meters indicates a significantly higher risk of death, aiding in patient stratification.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Exercise Physiology

Background:

  • The 6-minute walk test (6MWT) is frequently used in clinical practice.
  • Its prognostic value in stable outpatients with heart failure requires further evaluation.

Purpose of the Study:

  • To assess the prognostic significance of the 6-minute walk test distance in stable heart failure outpatients.
  • To determine if 6MWT distance can predict mortality and heart failure-related death.

Main Methods:

  • Analysis of 541 patients from the Digitalis Investigation Group trial.
  • Patients categorized by 6MWT distance: <=200 m, 201-300 m, 301-400 m, and >400 m.
  • Median follow-up of 32 months, assessing all-cause mortality and heart failure-specific death.

Main Results:

  • Patients walking <=200 m had significantly higher all-cause mortality (43.9%) compared to those walking >200 m (23.3%, P<0.001).
  • Mortality rates were similar for patients walking >200 m (23.7% to 19.8%, P for trend 0.45).
  • Distance <=200 m was associated with increased mortality (HR 1.47) and death from worsening heart failure (HR 2.89) in multivariable analysis.

Conclusions:

  • The 6-minute walk test effectively identifies patients walking <=200 m as having a markedly increased risk of death.
  • Standardizing the 6-minute walk test to a time- and distance-based protocol could enhance its efficiency while preserving prognostic information.
Abstract

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