Hendrican M C, McKelvie R S, Smith T, McCartney N, Pogue J, Teo K K, Yusuf S
Department of Medicine, Hamilton Civic Hospitals Research Centre, Hamilton General Hospital, McMaster University, Ontario, Canada.
J Card Fail. 2000 Sep;6(3):214-9. doi: 10.1054/jcaf.2000.8830.
Six-minute walk distance (6MWd) is related to activities of daily living and is also an independent predictor of prognosis in patients with congestive heart failure (CHF). Therefore, it is important to determine factors that contribute to the variability of this test.
We assessed the relationship between 6MWd and peak aerobic capacity (VO2) and dynamic muscle strength in 180 patients with CHF (age, 66+/-10 years; 146 men, 34 women; ejection fraction, .29+/-0.08). We also hypothesized that a measure of work performed during the walk test (6MWw) would be a better indicator of exercise capacity than 6MWd. The 6MWd had weak to moderate correlations with dynamic muscle strength (r = 0.33 to 0.41) and peak VO2 (r = 0.48). However, 6MWw was strongly related to dynamic muscle strength (r = 0.63 to 0.70) and peak VO2 (r = 0.77). Multivariate analysis indicated that a model combining dynamic muscle strength and peak VO2 explained 69% of the variance in 6MWw, more than with peak VO2 alone (R2 = 0.59).
Compared with 6MWd, 6MWw correlates significantly better with peak VO2 and dynamic muscle strength, suggesting that 6MWw may be a better reflection of a patient's exercise capacity. Furthermore, these results suggest that an exercise program combining both aerobic and strength training in patients with CHF may improve 6MWw and therefore 6MWd.
六分钟步行距离（6MWd）与日常生活活动相关，也是充血性心力衰竭（CHF）患者预后的独立预测指标。因此，确定导致该测试变异性的因素很重要。
我们评估了180例CHF患者（年龄66±10岁；男性146例，女性34例；射血分数0.29±0.08）的6MWd与峰值有氧能力（VO2）及动态肌肉力量之间的关系。我们还假设步行测试期间的工作量测量值（6MWw）比6MWd更能反映运动能力。6MWd与动态肌肉力量（r = 0.33至0.41）和峰值VO2（r = 0.48）呈弱至中度相关。然而，6MWw与动态肌肉力量（r = 0.63至0.70）和峰值VO2（r = 0.77）密切相关。多变量分析表明，结合动态肌肉力量和峰值VO2的模型可解释6MWw中69%的方差，比仅使用峰值VO2时更多（R2 = ）。
与6MWd相比，6MWw与峰值VO2和动态肌肉力量的相关性显著更好，表明6MWw可能更能反映患者的运动能力。此外，这些结果表明，CHF患者进行有氧训练和力量训练相结合的运动计划可能会改善6MWw，进而改善6MWd。 （注：原文中“R2 = 0.59”后面括号里数据缺失，翻译时保留原文格式）
