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Titolo:
Six-minute walking performance in patients with moderate-to-severe heart failure - Is it a useful indicator in clinical practice?
Autore:
Opasich, C; Pinna, GD; Mazza, A; Febo, O; Riccardi, R; Riccardi, PG; Capomolla, S; Forni, G; Cobelli, F; Tavazzi, L;
Indirizzi:
Fdn S Maugeri, Div Cardiol, Inst Care & Sci Res, Med Ctr Pavia, I-27100 Pavia, Italy Fdn S Maugeri Pavia Italy I-27100 s, Med Ctr Pavia, I-27100 Pavia, Italy Med Ctr Montescano PV, Dept Biomed Engn, Montescano, Italy Med Ctr Montescano PV Montescano Italy t Biomed Engn, Montescano, Italy Policlin San Matteo, Inst Care & Sci Res, Dept Cardiol, I-27100 Pavia, Italy Policlin San Matteo Pavia Italy I-27100 pt Cardiol, I-27100 Pavia, Italy
Titolo Testata:
EUROPEAN HEART JOURNAL
fascicolo: 6, volume: 22, anno: 2001,
pagine: 488 - 496
SICI:
0195-668X(200103)22:6<488:SWPIPW>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
PEAK OXYGEN-UPTAKE; DILATED CARDIOMYOPATHY; DOUBLE-BLIND; CARVEDILOL; PROGNOSIS; SURVIVAL; CONSUMPTION; MORTALITY; MORBIDITY; CAPACITY;
Keywords:
heart failure; prognosis; exercise; walk test; risk factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Opasich, C Fdn S Maugeri, Div Cardiol, Inst Care & Sci Res, Med Ctr Pavia,Via Ferrata 4, I-27100 Pavia, Italy Fdn S Maugeri Via Ferrata 4 Pavia Italy I-27100 0 Pavia, Italy
Citazione:
C. Opasich et al., "Six-minute walking performance in patients with moderate-to-severe heart failure - Is it a useful indicator in clinical practice?", EUR HEART J, 22(6), 2001, pp. 488-496

Abstract

Aims The 6-min walk test has been incorporated into studies on the efficacy of new therapies and into prognostic stratification for chronic heart failure patients. Firm conclusions on the usefulness of the test in clinical practice are still lacking. The aim of this study was to investigate (1) thecorrelation between walk test performance and standard indices of cardiac function and exercise capacity, and (2) the prognostic value of the walk test with respect to peak VO2 and NYHA class. Methods and Results Three hundred and fifteen chronic heart failure patients (age: 53 +/- 9 years, NYHA class. II (182), III (133)) underwent a functional evaluation and a 6-min walk test. Of these, 270 were followed-up for a minimum of 6 months (mean 387 +/- 177 days). Walked distance was 396 +/- 92 m. There was no significant correlation between distance walked and central haemodynamic data. Functional capacity, as measured by ergometry, correlated moderately with distance walked (duration: r=0.48, peak VO2: r=0.59, anaerobic threshold: r=0.54; all P<0.001). During follow-up, 46 patients died from cardiovascular causes and 12 were urgently transplanted. Either of these events were considered end points of the study. Survival analysis wasperformed from a continuous walk test and peak VO2 measurements or after categorization of (a) quartile segmentation, (b) cut-off points from the literature and (c) thresholds from receiver operating characteristic curves. Pit univariate survival analysis (Cox regression), the association of the walk test with survival was of significance (P=0.03, continuous variable), orborderline significance (0.05<less than or equal to>P less than or equal to0.1, after categorization). Peak VO2 was always significant, indepedent ofthe scale used (0.005 less than or equal toP less than or equal to0.03). The strongest association was found for NYHA class (P<0.001), which showed the highest sensitivity and specificity for the prediction of the event (0.64 and 0.65, respectively). When walk test performance, continuous or categorized, was entered into a multivariate model with NYHA class or peak VO2 itlost any significant association with survival (P>0.76 in all models with NYHA class and P>0.27 in all models with peak VO2). Conclusion In moderate-to-severe chronic heart failure patients, the 6-minwalk test is not related to cardiac function and only moderately related to exercise capacity. Walking performance does not provide prognostic information which can complement or substitute for that provided by peak VO2 or NYHA class. Hence the test is of limited usefulness as a decisional indicator in clinical practice. (C) 2001 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 01:13:23