The 6-minute walk as an appropriate exercise test in elderly patients with chronic heart failure

The value of the 6-minute walk in a population of elderly patients with chronic heart failure (CHF) has not yet been established, as it has been in a younger population.

In a prospective trial, 2 exercise tests were compared: the 6-minute walk (6 MW) and a treadmill test with progressive increments in workload. 37 patients (mean age 81.3, SD 5.6 years): 11 untrained controls, 16 patients with New York Heart Association (NYHA) class II and 10 patients with NYHA class III participated. The main outcome measures were the distance walked in 6 minutes, the symptomatic VO2max in the progressive treadmill test and the degree of CHF as scored by the NYHA classification and the Boston Study Group (BSG) score.

For both the 6 MW and the treadmill test there was a significant difference in distance between NYHA class II and III patients (p < .001), between the controls and NYHA class III patients (p < .001), but not between the controls and NYHA class II patients. The distance walked in the 6 MW was well correlated with the distance walked in the treadmill test (p < .001). Eight participants (22%), however, were unable to perform this treadmill test and 6 participants (17%) covered very low distances compared to the 6 MW. The VO2max was lower in NYHA class III than in class II patients (p = .032). NYHA classification and BSG score correlated reasonably well.

A treadmill exercise test with VO2max measurement in elderly patients with CHF is difficult to accomplish. On the contrary, the 6 MW gives a good impression of the remaining exercise capacity. It is well correlated with the treadmill test. The 6 MW is well tolerated by elderly patients and differentiates between NYHA classes II and III. Untrained controls could not be differentiated from NYHA class II patients.