Since the 6-minute walk test has been used to examine the physical capacity of heart failure patients for nearly 30 years, the prognostic value of the test
selleck inhibitor could have been modulated by the changing standards of pharmacotherapy and invasive treatment, irrespective of the clinical characteristics of participants. However, because the test remains prognostic, it should be a component of the complex evaluation of the heart failure patient, allowing the establishment of a prognosis. Most studies analysing the usefulness of the 6-minute walk test for stratification of mortality risk included participants with stable systolic heart failure. However, those experiments differed in terms of follow-up duration, size of examined groups, and the participants’ age and clinical characteristics (Cahalin et al 1996, Rubim et al 2006, Bettencourt et al 2000, Boxer et al 2010, Reibis et al 2010, Castel et al 2009). Furthermore, LY2157299 the prognostic value of the 6-minute walk test was also confirmed in patients with dilated cardiomyopathy (Zugck et al 2000) as well as in African American patients hospitalised due to acute decompensated heart failure (Alahdab et al 2009). Our study is unusual because the prognostic value of the 6-minute walk test was analysed over three years. In most previous studies, the
prognostic value of the 6-minute walk test was analysed over one year (Cahalin et al 1996, Opasich et al 2001), 18 months (Zugck et al 2000, Bettencourt et al 2000, Rubim et most al 2006), or two years (Reibis et al 2010, Castel et al 2009). Boxer et al (2010) observed that increasing the walking distance by 30Â m reduces the mortality risk of heart failure patients irrespective of their age, NYHA class, and hsCRP level. One should note, however, that this analysis included a small number of participants: only 60 participants were examined, of whom 20 were excluded from the analysis due to other chronic conditions or loss to follow-up. Nevertheless, the findings of that study were
confirmed by other authors who observed that a greater distance in a 6-minute walk test is associated with reduced cardiovascular mortality and this effect occurs irrespective of the person’s age (Alahdab et al 2009, Rubim et al 2006), NYHA class (Boxer et al 2010, Reibis et al 2010), LVEF (Zugck et al 2000, Rubim et al 2006, Castel et al 2009), or hsCRP (Boxer et al 2010). Another important finding of our study is that the 6-minute walk test remained predictive when hospitalisation for cardiovascular reasons was incorporated with death into a composite outcome. A relationship between the 6-minute walk test distance and hospitalisation has only been reported in single studies involving clinically and anthropometrically diverse groups of heart failure patients.