title: The long-term prognostic significance of 6-minute walk test distance in patients with chronic heart failure.
abstract: BACKGROUND
  The 6-minute walk test (6-MWT) is used to assess patients with chronic heart failure (CHF). The prognostic significance of the 6-MWT distance during long-term followup (>5 years) is unclear.
  
  
  METHODS
  1,667 patients (median [inter-quartile range, IQR]) (age 72 [65-77]; 75% males) with heart failure due to left ventricular systolic impairment undertook a 6-MWT as part of their baseline assessment and were followed up for 5 years.
  
  
  RESULTS
  At 5 years' followup, those patients who died (n = 959) were older at baseline and had a higher log NT pro-BNP than those who survived to 5 years (n = 708). 6-MWT distance was lower in those who died [163 (153) m versus 269 (160) m; P < 0.0001]. Median 6-MWT distance was 300 (150-376) m, and quartile ranges were <46 m, 46-240 m, 241-360 m, and >360 m. 6-MWT distance was a predictor of all-cause mortality (HR 0.97; 95% CI 0.96-0.97; Chi-square = 184.1; P < 0.0001). Independent predictors of all-cause mortality were decreasing 6-MWT distance, increasing age, increasing NYHA classification, increasing log NT pro-BNP, decreasing diastolic blood pressure, decreasing sodium, and increasing urea.
  
  
  CONCLUSIONS
  The 6-MWT is an important independent predictor of all-cause mortality following long-term followup in patients with CHF.
authors.affiliation: Department of Sport, Health & Exercise Science, University of Hull, 104 Don Building, Cottingham Road, Kingston upon Hull, HU7 6RX, UK.
authors.forename: Lee
authors.identifier: 0000-0001-6155-5577
authors.initials: L
authors.lastname: Ingle
authors.affiliation: National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.
authors.forename: John G
authors.initials: JG
authors.lastname: Cleland
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Kingston uponHull, HU16 5JQ, UK.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D016138:Walking