Longitudinal Remote 6-Minute Walk Distance and Cardiac Effort Using Wearable Sensors in Pulmonary Hypertension

Area of Science:

• Cardiology
• Pulmonology
• Biomedical Engineering

Background:

• Remote 6-minute walk testing (6MWT) in pulmonary hypertension (PH) shows safety but lacks data on longitudinal durability and correlation with in-clinic tests.
• Cardiac Effort (CE) offers physiologic context beyond walk distance alone.

Purpose of the Study:

• To evaluate the longitudinal performance and durability of home-based 6MWT and CE using wearable sensors.
• To compare remote home testing with supervised in-clinic testing over an 8-week period in PH patients.

Main Methods:

• A prospective, single-center study involving 29 PH participants.
• Participants underwent supervised in-clinic and unsupervised home 6MWTs at baseline and Week 8.
• A wearable chest sensor recorded heart rate and acceleration to estimate distance and calculate CE, with analysis using mixed-effects models and Bland-Altman analyses.

Main Results:

• Sensor-estimated 6MWT distance and CE showed minimal bias and excellent agreement with in-clinic measurements (ICC > 0.995).
• Home-based 6MWD was approximately 40m lower than clinic-based testing, but longitudinal changes correlated significantly between home and clinic (6MWD r=0.40, CE r=0.42).
• No adverse events were reported during remote testing.

Conclusions:

• Home-based 6MWT and CE using wearable sensors are safe, feasible, and reliable for remote functional assessment in PH.
• This approach demonstrates longitudinal tracking comparable to in-clinic testing, potentially enabling earlier detection of clinical changes and improved therapeutic management.
• Frequent remote monitoring can expand access to standardized physiologic assessment for PH patients.