Six-minute walk distance and long-term outcomes in contemporary left ventricular assist device recipients: the...

This study aimed to assess the prognostic value of Six-minute Walk Distance (6MWD) in stable HeartMate 3 (HM3) recipients.

Data from patients with available 6MWD at six months post-implant were obtained from the prospective, multicenter ELEVATE registry. Overall survival and adverse event rates were analyzed using Cox regression models adjusted for age and sex, with 6MWD as a continuous predictor, and stratified by median distance (350 m).

6MWD at six months was available in 194 HM3 recipients. Patients walking 350 m showed no significant differences in survival (log-rank p = 0.379), right heart failure (p = 0.334), or rehospitalization (p = 0.243), while survival free from hemocompatibility-related adverse events differed significantly, although marginally (p = 0.049). Cox models confirmed that 6MWD had no independent prognostic value for mortality (HR 0.98, 95% CI 0.96-1.01, p = 0.26) or secondary outcomes. However, patients with

Shorter 6MWD six months after HM3 implantation was associated with a higher risk of some AEs but was not prognostic for mortality, HF recurrence, or rehospitalization risk. The prognostic value of 6MWD in HF patients without circulatory support cannot be extrapolated to patients treated with current LVADs.