Prognostic value of 6-minute walk corridor testing in women with mild to moderate heart failure.
BACKGROUND
The prognostic usefulness of 6-min walk testing (6 MWT) was reported both in patients with severe as well as in those with moderate systolic heart failure. However, more than 80% of the patients investigated were males and the value of the test had never been separately evaluated in women. The aim of the present study was to prospectively assess the prognostic value of 6 MWT in women with mild to moderate congestive heart failure.


METHODS
Ninety-five women with congestive heart failure (mean age 63.9 years) were enrolled in the study. All patients were followed for a mean period of 38 months in order to assess the event-free survival (death, heart transplantation). The prognostic value of the distance walked during 6 MWT was compared to the NYHA functional classification and to the echocardiographically-derived indexes of heart function. The results were then compared with those of a group of 129 male patients with similar clinical characteristics.


RESULTS
Thirty-four female patients (36%) died of cardiovascular causes and 2 underwent heart transplantation. In the same period, the overall survival in male patients was 74% and 3 patients were successfully transplanted. Regardless of gender, the 3-year event-free survival was significantly lower in patients who walked < 300 m during 6 MWT compared to that observed in those with an intermediate (300-400 m) or high level (> 400 m) of performance. At univariate and multivariate analyses, the NYHA class and the distance covered during 6 MWT were significantly related to survival in both genders while with regard to the left ventricular ejection fraction, this relationship was observed only in women. The patient's age was not related to the mortality.


CONCLUSIONS
A distance < 300 m during 6 MWT identifies a subgroup at high risk of death even in female patients with mild to moderate heart failure.
Rostagno
Carlo
C
Department of Internal Medicine and Cardiology, University of Florence, Florence, Italy. rostagnocarlo@katamail.com
Galanti
Giorgio
G
Romano
Mario
M
Chiostri
Gabriele
G
Gensini
Gian Franco
GF
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D016387:Women's Health