Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investigators.
OBJECTIVE
To study the potential usefulness of the 6-minute walk test, a self-paced submaximal exercise test, as a prognostic indicator in patients with left ventricular dysfunction.


METHODS
Data were collected during a prospective cohort study, the Studies of Left Ventricular Dysfunction (SOLVD) Registry Substudy.


METHODS
Twenty tertiary care hospitals in the United States, Canada, and Belgium.


METHODS
A stratified random sample of 898 patients from the SOLVD Registry who had either radiological evidence of congestive heart failure and/or an ejection fraction of 0.45 or less were enrolled in the substudy and underwent a detailed clinical evaluation including a 6-minute walk test. Patients were followed up for a mean of 242 days.


METHODS
Mortality and hospitalization.


RESULTS
During follow-up, 52 walk-test participants (6.2%) died and 252 (30.3%) were hospitalized. Hospitalization for congestive heart failure occurred in 78 participants (9.4%), and the combined endpoint of death or hospitalization for congestive heart failure occurred in 114 walk-test participants (13.7%). Compared with the highest performance level, patients in the lowest performance level had a significantly greater chance of dying (10.23% vs 2.99%; P = .01), of being hospitalized (40.91% vs 19.90%; P = .002), and of being hospitalized for heart failure (22.16% vs 1.99%; P < .0001). In a logistic regression model, ejection fraction and distance walked were equally strong and independent predictors of mortality and heart failure hospitalization rates during follow-up.


CONCLUSIONS
The 6-minute walk test is a safe and simple clinical tool that strongly and independently predicts morbidity and mortality in patients with left ventricular dysfunction.
Bittner
V
V
Department of Medicine, University of Alabama at Birmingham 35294.
Weiner
D H
DH
Yusuf
S
S
Rogers
W J
WJ
McIntyre
K M
KM
Bangdiwala
S I
SI
Kronenberg
M W
MW
Kostis
J B
JB
Kohn
R M
RM
Guillotte
M
M
D000368:Aged; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology; D016138:Walking