CardioVascular Center Frankfurt, Seckbacher Landstraße 65, 60389, Frankfurt, Germany.
Universitäres Herzzentrum Eppendorf, Hamburg, Germany.
Clin Res Cardiol. 2018 Mar;107(3):241-248. doi: 10.1007/s00392-017-1177-z. Epub 2017 Dec 5.
The 6-min walk test (6 MWT) has been established as an important tool for functional assessment in heart failure patients. However, its prognostic impact on the outcome in subjects with mitral regurgitation undergoing transcatheter mitral valve repair is unknown.
This present work represents a sub-analysis of the German, prospective, multicenter, Transcatheter Mitral Valve Interventions (TRAMI) registry. Of the main study cohort (n = 828) 326 patients underwent 6 MWT prior to the procedure. Patients were assigned to two groups depending on the preprocedural 6 MWT distance using the median (< 200 m [group 1] vs. ≥ 200 m [group 2]).
No differences regarding procedural success (97 vs. 96%; p = 0.71) and 30-day mortality (3 vs. 4%; p = 0.96) were observed between the groups. With regards to 1-year outcome, patients with a walking distance < 200 m had higher all-cause mortality (26 vs. 14%; p = 0.013) as compared to those with a 6 MWT distance 200 m. After adjustment of baseline risk factors, 6 MWT distance < 200 m still showed a strong trend towards increased 1-year all-cause mortality (HR 1.63, 95% confidence interval 0.96-2.76; p = 0.071).
In the present study preprocedural 6 MWT distance < 200 m showed a strong trend towards increased 1-year mortality in patients undergoing MitraClip implantation.
6 分钟步行试验（6MWT）已被确立为心力衰竭患者功能评估的重要工具。然而，其在接受经导管二尖瓣修复术的二尖瓣反流患者中的预后影响尚不清楚。
本研究是德国前瞻性多中心经导管二尖瓣介入治疗（TRAMI）注册研究的亚分析。在主要研究队列（n=828）中，326 例患者在术前进行了 6MWT。根据术前 6MWT 距离将患者分为两组（<200m[组 1]与≥200m[组 2]）。
两组在手术成功率（97%对 96%；p=0.71）和 30 天死亡率（3%对 4%；p=0.96）方面无差异。在 1 年结果方面，行走距离<200m 的患者全因死亡率较高（26%对 14%；p=0.013），与 6MWT 距离为 200m 的患者相比。在调整基线风险因素后，6MWT 距离<200m 仍显示出 1 年全因死亡率增加的强烈趋势（HR 1.63，95%置信区间 0.96-2.76；p=0.071）。
在本研究中，术前 6MWT 距离<200m 与接受 MitraClip 植入术的患者 1 年死亡率增加呈强相关趋势。
