title: Left ventricular asynchrony and raised filling pressure predict limited exercise performance assessed by 6 minute walk test.
abstract: BACKGROUND
  Six minute walking test (6-MWT) may serve as a reproducible test for assessing exercise capacity in heart failure (HF) patients and can be clinically predicted. We aimed in this study to ascertain if global markers of ventricular asynchrony can predict 6MWT distance in a group of patients with HF and left ventricular (LV) ejection fraction (EF) <45%.
  
  
  RESULTS
  This study included 77 consecutive patients (60 ± 12 years) with stable HF. LV end-diastolic and end-systolic dimensions, shortening fraction (SF), EF, myocardial velocities, t-IVT, and Tei index were measured, as well as 6-MWT distance. Patients with limited exercise performance (≤ 300 m) had lower SF (p = 0.02) and EF (p = 0.017), longer t-IVT (p = 0.001), higher Tei index (p = 0.002) and higher E/E' ratio (p < 0.001) compared with good performance patients. In multivariate analysis, only E/E' ratio [0.800 (0.665-0.961), p = 0.017], and t-IVT [0.769 (0.619-0.955), p = 0.018] independently predicted poor exercise performance.
  
  
  CONCLUSIONS
  In heart failure patients, the higher the filling pressures and the more asynchronous the left ventricle, the poorer is the patient's exercise capacity. These findings highlight specific LV functional disturbances that should be targeted for better optimization of medical and/or electrical therapy.
authors.affiliation: Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo. ganibajraktari@yahoo.co.uk
authors.forename: Gani
authors.initials: G
authors.lastname: Bajraktari
authors.forename: Shpend
authors.initials: S
authors.lastname: Elezi
authors.forename: Venera
authors.initials: V
authors.lastname: Berisha
authors.forename: Per
authors.initials: P
authors.lastname: Lindqvist
authors.forename: Nehat
authors.initials: N
authors.lastname: Rexhepaj
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Henein
mesh_terms: D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016138:Walking