6分钟步行走廊试验对轻至中度心力衰竭患者的预后价值：与其他功能评估方法的比较

Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation.

作者信息

Rostagno Carlo, Olivo Giuseppe, Comeglio Marco, Boddi Vieri, Banchelli Michela, Galanti Giorgio, Gensini Gian Franco

机构信息

U.O. Clinica Medica e Cardiologia, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.

出版信息

Eur J Heart Fail. 2003 Jun;5(3):247-52. doi: 10.1016/s1388-9842(02)00244-1.

DOI:10.1016/s1388-9842(02)00244-1

PMID:12798821

Abstract

AIM

The study was designed to evaluate the prognostic value of the 6-min walk test (6MWT) in patients with mild to moderate congestive heart failure (CHF).

METHODS AND RESULTS

Two hundred and fourteen patients (119 men and 95 women, mean age 64 years) were followed for a mean period of 34 months to assess event-free survival (death, heart transplantation). Sixty-six patients (34%) died (63 cardiovascular causes, 2 cancer and 1 stroke) and five patients underwent heart transplantation. For patients who walked <300 m during the 6MWT, survival was 62% compared with 82% in patients who walked 300-450 m or>450 m. With univariate analysis, NYHA class was the strongest predictor of death. LVEF (P<0.0001), aetiology of heart failure (P<0.001), LV filling pattern (P=0.002) and 6MWT distance (P<0.01) were all significantly related to survival. No significant relationship was found between survival, peak oxygen consumption or anaerobic threshold. Multivariate analysis using the Cox-stepwise regression model showed that LV fractional shortening (P<0.009) and 6MWT distance (P<0.0005) were the strongest prognostic markers.

CONCLUSION

A 6MWT distance of <300 m is a simple and useful prognostic marker of subsequent cardiac death in unselected patients with mild to moderate CHF.

摘要

目的

本研究旨在评估6分钟步行试验（6MWT）对轻至中度充血性心力衰竭（CHF）患者的预后价值。

方法与结果

对214例患者（119例男性和95例女性，平均年龄64岁）进行了平均34个月的随访，以评估无事件生存期（死亡、心脏移植）。66例患者（34%）死亡（63例因心血管原因，2例因癌症，1例因中风），5例患者接受了心脏移植。在6MWT中步行距离<300米的患者生存率为62%，而步行300 - 450米或>450米的患者生存率为82%。单因素分析显示，纽约心脏协会（NYHA）分级是死亡的最强预测因素。左心室射血分数（LVEF，P<0.0001）、心力衰竭病因（P<0.001）、左心室充盈模式（P = 0.002）和6MWT距离（P<0.01）均与生存率显著相关。未发现生存率与峰值耗氧量或无氧阈值之间存在显著关系。使用Cox逐步回归模型进行的多因素分析显示，左心室缩短分数（P<0.009）和6MWT距离（P<0.0005）是最强的预后标志物。