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The reproducibility and sensitivity of the 6-min walk test in elderly patients with chronic heart failure
Open accessAbstract
AIMS: The 6-min walk test (6-MWT) is used to estimate functional capacity. However, in elderly patients with chronic heart failure (CHF): (i) 1 year reproducibility of the 6-MWT; (ii) sensitivity of the 6-MWT to self-perceived changes in symptoms of heart failure; and (iii) implications for patient numbers required for studies using the 6-MWT as an endpoint have not been described. METHODS AND RESULTS: One thousand and seventy-seven patients with CHF, aged>60, with NYHA Class > or =II were recruited. Heart failure symptom assessment was determined using a questionnaire related to aspects of physical function, and patients performed a baseline 6-MWT, with follow-up 1 year later. Seventy-four patients with unchanged symptoms had an unchanged 6-MWT distance, with an overall intraclass correlation coefficient of 0.80 (95% CI=0.69-0.87). Four hundred and twenty-three patients reported an improvement in symptoms during follow-up. There was a negative correlation (r=-0.55; P=0.0001) between Delta symptoms and Delta 6-MWT (i.e. a reduced 6-MWT distance is associated with reduced symptom severity at follow-up). Five hundred and sixteen patients reported worsening symptoms of heart failure, a moderate inverse correlation (r=-0.53; P=0.0001) was displayed between Delta symptoms and Delta 6-MWT. For all patients, irrespective of symptom status, a high inverse correlation (r=-0.75; P=0.0001) was evident. On the basis of the data for patients with unchanged symptoms, it is calculated that to detect an increase in 6-MWT of 50 m, with 90% power, a study size of approximately 120 is required. CONCLUSION: In elderly patients with CHF, the 6-MWT shows satisfactory agreement when repeated 1 year later. Change in 6-MWT distance is sensitive to change in self-perceived symptoms of heart failure.
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“The low sensitivity of NYHA classification and 6 min walk test limits their ability to measure change over time”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [39]
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“while the additional equipment to measure metabolic gas exchange limits the widespread applicability of cardiopulmonary exercise testing. 38 , 39”
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Metadata
- Authors
- Ingle, L., Shelton, R. J., Rigby, A. S., Nabb, S., Clark, A. L., & Cleland, J. G. F.
- Affiliations
- Castle Hill Hospital (GB)
- Corresponding author
- Ingle, Lee
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-04-14
- Volume
- 26
- Issue
- 17
- Pages
- 1742-1751
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2110020738
- Cited by
- 126
- References
- 53
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 6 · 2015: 10 · 2014: 6 · 2013: 4 · 2012: 4
- FWCI
- 23.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- 6-minute walk test, chronic heart failure, elderly patients, reproducibility, test sensitivity, functional capacity, heart failure symptoms, self-reported symptoms, sample size determination, exercise capacity
- MeSH terms
- Aged, Exercise Test, Female, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Prognosis, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Walking
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