Article ; Online: Prognostic Significance and Determinants of the 6-Min Walk Test in Patients With Heart Failure and Preserved Ejection Fraction.
2015 Volume 3, Issue 6, Page(s) 459–466
Abstract: ... of the 6-min walk distance (6-MWD) in affected patients.: Background: Symptoms of exertional fatigue and ...
Abstract | Objectives: This study sought to define the prognostic significance and clinical determinants of the 6-min walk distance (6-MWD) in affected patients. Background: Symptoms of exertional fatigue and dyspnea, as well as a reduced exercise tolerance, are cardinal features of pulmonary hypertension associated with heart failure and preserved ejection fraction (PH-HFpEF). Mechanisms limiting exercise capacity in this specific entity remain incompletely understood. Methods: Consecutive patients with PH-HFpEF, as confirmed by right heart catheter, were enrolled in our prospective registry. Hospitalization for HF and/or death for cardiac reasons were defined as primary outcome. Multiple regression models were constructed to establish determinants of the 6-MWD. For quantification of left ventricular (LV) extracellular matrix (ECM), myocardial biopsies were taken from 18 patients. Results: Between December 2010 and July 2013, 142 PH-HFpEF patients were included in the study. After a mean follow-up of 14.0 ± 10.0 months, 43 patients (30.3%) reached the combined endpoint. The 6-MWD was found to be an independent predictor of outcome and was influenced by a variety of clinical, echocardiographic, hemodynamic, laboratory, and pulmonary parameters. There was a significant inverse correlation between the 6-MWD and the extent of ECM in the LV myocardium. Conclusions: Impaired exercise capacity in PH-HFpEF patients is explained by cardiac and noncardiac factors. The 6-MWD predicts outcome and may be a useful endpoint in clinical trials. |
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MeSH term(s) | Aged ; Cardiac Catheterization ; Exercise Test ; Female ; Heart Failure/diagnosis ; Heart Failure/pathology ; Heart Failure/physiopathology ; Heart Ventricles/pathology ; Humans ; Male ; Prognosis ; Prospective Studies ; Stroke Volume/physiology ; Ventricular Dysfunction, Left/physiopathology ; Walking/physiology |
Language | English |
Publishing date | 2015-06 |
Publishing country | United States |
Document type | Journal Article ; Research Support, Non-U.S. Gov't |
ZDB-ID | 2705621-1 |
ISSN | 2213-1787 ; 2213-1779 |
ISSN (online) | 2213-1787 |
ISSN | 2213-1779 |
DOI | 10.1016/j.jchf.2015.01.010 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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