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Aerobic assessment remains good predictor of hospitalization, mortality
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The 6-minute walk test and cardiopulmonary exercise test demonstrated similar utility as predictors of all-cause hospitalization and mortality in outpatients with systolic HF, according to recent data.
The direct comparison study included 2,054 participants in the HF-ACTION study who underwent both 6-minute walk and cardiopulmonary exercise (CPX) tests. The mean age of the patients was 59 years; 71% were men and 64% had NYHA Class II systolic HF.
During a mean follow-up of 2.5 years, researchers compared 6-minute walk distance and CPX indices as predictors of all-cause mortality and all-cause mortality/hospitalization. According to results, C-indices of the 6-minute walk distance were 0.58 and 0.65 (unadjusted) for predicting all-cause mortality/hospitalization and 0.62 and 0.72 (adjusted) for predicting all-cause mortality. The models showed that C-indices for ventilation relative to carbon dioxide production (VE/VCO2slope) were 0.56 and 0.65 (unadjusted) and 0.61 and 0.71 (adjusted), respectively. C-indices did not improve when the researchers combined peak oxygen consumption (VO2) and VE/VCO2 slope.
“Overlapping 95% confidence intervals and modest integrated discrimination improvement values confirmed similar prognostic discrimination by 6-minute walk distance and CPX indices within adjusted models,” Daniel E. Forman, MD, of the division of cardiovascular medicine, Brigham and Women’s Hospital, Boston, and colleagues wrote in the study.
“These data suggest that a 6-minute walk test may be substituted for CPX testing as an inexpensive, practical, clinical tool to help gauge prognosis in the large and growing HF population.”
Disclosure:The researchers report no relevant financial disclosures.
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