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6-Min Walk Test Provides Prognostic Utility Comparable to Cardiopulmonary Exercise Testing in Ambulatory Outpatients With Systolic Heart Failure

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Forman, Daniel E., Fleg, Jerome L., Kitzman, Dalane W., Brawner, Clinton A., Swank, Ann M., McKelvie, Robert S., Clare, Robert M., Ellis, Stephen J., Dunlap, Mark E., Bittner, Vera·2012·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2012.08.1010
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Abstract

Objectives To compare the prognostic efficacy of 6MW and CPX tests in stable outpatients with chronic HF. Background Cardiopulmonary exercise (CPX) and 6 minute walk (6MW) tests are commonly applied as prognostic gauges for systolic heart failure (HF) patients, but few direct comparisons have been conducted. Methods Stable NYHA class II and III systolic HF patients (ejection fraction ≤35%) from Heart Failure: A Controlled Trial Investigating Outcomes of Exercise TraiNing (HF-ACTION) were studied. 6MW distance (6MWD) and CPX indices (peak oxygen consumption [VO2] and minute ventilation-carbon dioxide production [VE/VCO2] slope) were compared as predictors of all-cause mortality/hospitalization and all-cause mortality over 2.5 years mean follow-up. Results 2,054 HF-ACTION participants underwent both CPX and 6MW tests at baseline (median age 59 years; 71% male; 64% NYHA class II and 36% NYHA class III). In unadjusted models and in models that included key clinical and demographic covariates, C-indices of 6MWD were 0.58 and 0.65 (unadjusted) and 0.62 and 0.72 (adjusted) in predicting all-cause mortality/ hospitalization and all-cause mortality, respectively. C-indices for peak VO2 were 0.61 and 0.68 (unadjusted) and 0.63 and 0.73 (adjusted). C-indices for VE/VCO2 slope were C=0.56 and 0.65 (unadjusted) and 0.61 and 0.71 (adjusted); combining peak VO2 and VE/VCO2 slope did not improve C-indices. Overlapping 95% confidence intervals and modest integrated discrimination improvement values confirmed similar prognostic discrimination by 6MWD and CPX indices within adjusted models. Conclusion In systolic HF outpatients 6MWD and CPX indices demonstrated similar utility as univariate predictors for all-cause hospitalization/mortality and all-cause mortality. However, 6MWD or CPX indices added only modest prognostic discrimination to models that included important demographic and clinical covariates.

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Research works printed but not linked: 34

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Metadata

Authors
Forman, D. E., Fleg, J. L., Kitzman, D. W., Brawner, C. A., Swank, A. M., McKelvie, R. S., Clare, R. M., Ellis, S. J., Dunlap, M. E., & Bittner, V.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2012-12
Volume
60
Issue
25
Pages
2653-2661
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2012.08.1010
OpenAlex
W1999968533
Cited by
220
References
4
FWCI
34.31
Type
journal article
Language
en
Open access
bronze
Licence

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CoChat. (2026). Citation check: 6-Min Walk Test Provides Prognostic Utility Comparable to Cardiopulmonary Exercise Testing in Ambulatory Outpatients With Systolic Heart Failure. https://app.cochat.ai/papers/10.1016/j.jacc.2012.08.1010
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Forman, D. E., Fleg, J. L., Kitzman, D. W., Brawner, C. A., Swank, A. M., McKelvie, R. S., Clare, R. M., Ellis, S. J., Dunlap, M. E., & Bittner, V. (2012). 6-Min Walk Test Provides Prognostic Utility Comparable to Cardiopulmonary Exercise Testing in Ambulatory Outpatients With Systolic Heart Failure. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2012.08.1010

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