title: Prognostic value of serial six-minute walk tests using tele-accelerometry in patients with chronic heart failure: A pre-specified sub-study of the TIM-HF-Trial.
abstract: The six-minute walk test (6MWT) is an established functional test assessing exercise capacity and is used to predict clinical prognosis in patients with chronic heart failure (HF). Tele-accelerometry is a novel approach to activity monitoring using telemedical data transfer and allows a Tele-6MWT to be performed in an outpatient setting. It offers patients the option of performing simple serial follow-up tests in their own home.
  
  
  
  The aim of this study was to investigate the prognostic value of serial Tele-6MWTs using tele-accelerometry in patients with HF.
  
  
  
  In this proof-of-concept study, 155 patients with HF completed the Tele-6MWT in an outdoor setting once per month over a period of 0.25-21 months. We analysed the differences in the number of steps over time to predict hospitalization as a result of HF or death.
  
  
  
  Patients with at least one event (n = 31) recorded a lower number of steps and a shorter distance in Tele-6MWT at baseline compared with patients who remained event-free (n = 124) (540.1 ± 78.4 steps vs. 601.8 ± 76.7 steps, P < 0.001 respectively; 353.2 ± 82.4 m vs. 418.8 ± 95.6 m, P < 0.001). Patients (n = 19) who performed more than one Tele-6MWT prior to a clinical event showed no significant difference in the number of steps, regardless of whether the baseline test was compared with the last Tele-6MWT before the event or with the last two tests before the event.
  
  
  
  Tele-6MWT has a high predictive value with respect to hospitalization as a result of HF or death from any cause and the results were comparable with the prognostic impact of a conventional 6MWT. Therefore Tele-6MWT may be used as alternative test method in the home environment. However, there is no added prognostic value of repeating Tele-6MWTs on a monthly basis.
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Prescher
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schoebel
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Koehler
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Deckwart
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
authors.forename: Brunhilde
authors.initials: B
authors.lastname: Wellge
authors.affiliation: Kardiologische Praxis, Gerlingen, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Honold
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.|Dr Oliver Hartmann Statistical Consulting, Frankfurt/Main, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Hartmann
authors.affiliation: Department of Internal Medicine/Cardiology, Unfallkrankenhaus Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Winkler
authors.affiliation: Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany friedrich.koehler@charite.de.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Koehler
mesh_terms: D056044:Actigraphy / Q000379:methods*; D000368:Aged; D002908:Chronic Disease; D018450:Disease Progression; D018572:Disease-Free Survival; D017079:Exercise Tolerance; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D000075082:Proof of Concept Study; D017216:Telemedicine / Q000379:methods*; D013686:Telemetry / Q000379:methods*; D013997:Time Factors; D000070857:Walk Test / Q000379:methods*; D016138:Walking
keywords: Six-minute walk test; TIM-HF; activity monitoring; heart failure; remote patient management; tele-accelerometry; telemedicine