Berisha Venera, Bajraktari Gani, Dobra Dritero, Haliti Edmond, Bajrami Reshat, Elezi Shpend
Segunda Divisão de Cardiologia, Clínica Geral, Universidade Centro Clínico de Kosova, Prishtina, Kosovo.
Arq Bras Cardiol. 2009 Feb;92(2):121-34. doi: 10.1590/s0066-782x2009000200009.
Chronic heart failure is a major cardiovascular disorder.
The aim of this study was to prospectively examine whether a 6-min walk test (6-MWT) result correlates with echocardiographic variables in patients with left ventricular systolic dysfunction and stable chronic heart failure.
We prospectively studied 52 patients (65% male; mean age 60+/-11 years) who had chronic heart failure secondary to ischemic heart disease or idiopathic cardiomyopathy. All patients had left ventricular systolic dysfunction (ejection fraction <or= 0.45), and were in stable NYHA class II or III heart failure. An echo-Doppler study and a 6-MWT were performed on the same day.
6-MWT had moderate, but statistically significant correlation with end-systolic diameter (ESD) (r=-0.46; p=0.0006), with shortening fraction-SF (r=0.52; p=0.0001), and with ejection fraction-EF (r=0.5; p=0.0001), whereas it had poor, but statistically significant correlation with myocardial performance index-MPI (r=-0.39; p=0.0046), E/A(tricuspid) ratio (r=-0.333; p=0.016), pulmonary acceleration time (r=0.328; p=0.018), and lateral long axis amplitude (r=0.283; p=0.04). Linear regression model demonstrated that age (chi2=-0.59, p=<0.001), restrictive transmitral filling pattern (chi2=-0.44, p=0.004) and left ventricular end-systolic dimension (chi2=-0.34, p=0.012) were independent factors that influenced the 6-MWT.
In patients with heart failure due to left ventricular systolic dysfunction, the 6-MWT as a clinical assessment tool of the functional capacity has a significant correlation with the most important global LV systolic function parameters, as well as with LV MPI. In patients with LV systolic dysfunction, age, restrictive transmitral filling pattern, and left ventricular systolic dimension, were independently associated with the 6-MWT.
慢性心力衰竭是一种主要的心血管疾病。
本研究旨在前瞻性地检验6分钟步行试验(6-MWT)结果是否与左心室收缩功能障碍和稳定型慢性心力衰竭患者的超声心动图变量相关。
我们前瞻性地研究了52例患者(65%为男性;平均年龄60±11岁),这些患者患有缺血性心脏病或特发性心肌病继发的慢性心力衰竭。所有患者均有左心室收缩功能障碍(射血分数≤0.45),且处于纽约心脏协会(NYHA)II级或III级稳定心力衰竭状态。在同一天进行了超声多普勒研究和6-MWT。
6-MWT与收缩末期直径(ESD)呈中度但具有统计学意义的相关性(r=-0.46;p=0.0006),与缩短分数-SF(r=0.52;p=0.0001)以及射血分数-EF(r=0.5;p=0.0001)相关,而与心肌性能指数-MPI(r=-0.39;p=0.0046)、E/A(三尖瓣)比值(r=-0.333;p=0.016)、肺加速时间(r=0.328;p=0.018)和外侧长轴振幅(r=0.283;p=0.04)呈弱但具有统计学意义的相关性。线性回归模型表明,年龄(χ2=-0.59,p<0.001)、限制性二尖瓣充盈模式(χ2=-0.44,p=0.004)和左心室收缩末期内径(χ2=-0.34,p=0.012)是影响6-MWT的独立因素。
在左心室收缩功能障碍导致的心力衰竭患者中,6-MWT作为功能能力的临床评估工具,与最重要的左心室整体收缩功能参数以及左心室MPI具有显著相关性。在左心室收缩功能障碍患者中,年龄、限制性二尖瓣充盈模式和左心室收缩内径与6-MWT独立相关。