Functional limitation predicts mortality in heart failure with preserved ejection fraction

Area of Science:

• Cardiology
• Clinical Medicine
• Prognostics

Background:

• The prognostic value of the six-minute walking test (6MWT) is established for heart failure with reduced ejection fraction (HFrEF).
• Limited data exist on the correlation between 6MWD and mortality in heart failure with preserved ejection fraction (HFpEF).

Purpose of the Study:

• To investigate the association between the distance walked during the 6MWT (6MWD) and 3-year all-cause mortality in patients with HFpEF.
• To determine if 6MWD provides prognostic information in HFpEF.

Main Methods:

• A cohort of 482 patients with HFpEF admitted to inpatient cardiac rehabilitation was studied.
• The primary outcome was 3-year all-cause mortality.
• Multivariable models incorporating established risk markers were used to assess the association between 6MWD and mortality.

Main Results:

• During 3-year follow-up, 174 patients died.
• Patients in the lowest tertile of 6MWD (≤240 m) had a significantly higher adjusted hazard ratio (HR) for mortality (4.94) compared to the highest tertile (≥360 m).
• When normalized for age, sex, and BMI, the lowest tertile of percent-of-predicted walking distance (≤58.1%) showed a higher adjusted HR (3.52) for mortality.

Conclusions:

• The distance walked during the 6MWT provides significant prognostic information in patients with HFpEF.
• Assessing functional capacity through 6MWT is valuable for risk stratification in HFpEF.
• Lower functional capacity, as measured by 6MWD, is associated with increased mortality risk in HFpEF.