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Systemic sclerosis patients’ decreased capacity in walk test reflected vascular, heart dysfunction
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Six-minute walk test results among patients with systemic sclerosis showed a possible link between decreased exercise capacity and vascular and heart dysfunction, according to recent study data.
Researchers in Warsaw, Poland, evaluated 111 patients with systemic sclerosis (SSc; mean age, 54.2 years; 101 women; mean disease duration, 9 years) and a control group of 21 age-matched participants (mean age, 49.3 years; 18 women). Participants underwent standard evaluation, 6-minute walk test (6MWT) on a level surface and transthoracic echocardiography. Serum endothelin-1 (ET-1) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels were measured from blood samples.
The SSc patients’ mean 6MWT distance results (514.7 ± 102.5 m) were significantly shorter compared with controls (562.8 ± 60.3m; P=.03). ET-1 (r=–0.47; P<.0001), NT-proBNP levels (r=–0.36; P=.0008) and echocardiographic indices acceleration time of pulmonary ejection (r=0.37; P=.0002) and tricuspid regurgitation peak gradient (r=–0.36; P=.0011) correlated with the SSc patients’ 6MWT distance.
Researchers also said SSc patients who traveled less than 450 m (n=20) in 6MWT displayed greater NT-proBNP (311.2 pg/mL, 31.1-17,237 vs. 105.3 pg/mL, 5-17,670; P=.0138) and ET=1 levels than those of patients (n=73) who walked 450 m or farther (2.9 ± 2.2 pg/mL vs. 1.4 ± 0.7 pg/mL; P=.0032).
“Decreased exercise capacity significantly correlates with biochemical and echocardiographic parameters of right ventricular dysfunction and neurohormonal activation providing a potential link for neuroendocrine derangement in patients with SSc,” the researchers concluded. “As a simple and inexpensive diagnostic tool, [6MWT] can be used in the assessment of heart and pulmonary function.”
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