Continuous central haemodynamic measurements during the six-minute walk test and daily life in patients with chronic heart failure.
OBJECTIVE
To compare haemodynamic responses during the 6-min walk test (6MWT) and daily living activities in heart failure (HF) patients.


RESULTS
Eighteen HF patients received an implantable haemodynamic monitor, which continuously measured heart rate (HR), estimated pulmonary artery diastolic pressure (ePAD), and several right ventricular (RV) pressure parameters. During the 6MWT, haemodynamics were assessed at rest and peak exercise. Ambulatory values were measured as the daily minimum, maximum, and median, averaged over the 14-day period surrounding each 6MWT. During the 6MWT, HR increased from 71 +/- 17 to 101 +/- 20 b.p.m. and ePAD from 20 +/- 5 to 34 +/- 8 mmHg. Daily minimum values were significantly lower and daily maximum values higher compared with rest and peak exercise. Patients with a walked distance above the median (402 m) had lower resting HR (64 +/- 10 vs. 77 +/- 20, P = 0.001) and ePAD (18 +/- 4 vs. 21 +/- 7, P = 0.022) compared to patients with walked distances below the median; values at peak exercise were similar. This pattern was also observed during the ambulatory periods.


CONCLUSIONS
Ranges of HR and RV pressures are significantly larger during daily living activities compared with 6MWT in HF patients. Haemodynamic characteristics of patients with greater exercise capacity include lower resting HR and RV pressures and are similar during the 6MWT and daily life.
Braunschweig
Frieder
F
Department of Cardiology, Karolinska Institutet, S-171 76, Stockholm, Sweden. frieder.braunschweig@karolinska.se
Linde
Cecilia
C
Adamson
Philip B
PB
Magalski
Anthony
A
Erdmann
Erland
E
Kjellstrom
Barbro
B
Bennett
Tom
T
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D013997:Time Factors; D017725:Ventricular Pressure / Q000502:physiology*; D016138:Walking / Q000502:physiology*