University of Alberta, and Covenant Health, Misericordia Hospital, Suite 362, Heritage Medical Research Centre, Edmonton, AB, T6G 2C8, Canada.
University of East Anglia and Norfolk and Norwich University Hospital, Norwich, UK.
Clin Res Cardiol. 2021 Aug;110(8):1193-1201. doi: 10.1007/s00392-020-01768-w. Epub 2020 Nov 2.
There is limited information about the 6-min walk test (6MWT) in elderly patients with heart failure. We evaluated 6MWT and the effect of nebivolol on 6MWT from the SENIORS trial.
The SENIORS trial evaluated nebivolol versus placebo on death and hospitalisation in patients aged ≥ 70 years with heart failure. A total of 1982 patients undertook a 6MWT at baseline and 1716 patients at 6 months. Patients were divided into tertiles (≤ 200 m, 201 to ≤ 300 m and > 300 m) and to change in distance walked between baseline and 6 months (< 0 m, 0 to < 30 m and ≥ 30 m). The primary outcome was all-cause mortality and cardiovascular hospital admission. Secondary endpoint was all-cause mortality. Baseline walk distance of ≤ 200 m incurred a greater risk of the primary and secondary outcomes (HR 1.41, CI 95% 1.17-1.69, p < 0.001) and (HR 1.37, CI 95% 1.05-1.78, p = 0.019). A decline in walk distance over 6 months was associated with increased risk of clinical events. Nebivolol had no influence on change in walk distance over 6 months.
The 6MWT has prognostic utility in elderly patients. Those who walked less than 200 m were at highest risk. Nebivolol had no effect on 6MWT.
心力衰竭老年患者的 6 分钟步行试验（6MWT）相关信息有限。我们从 SENIORS 试验中评估了 6MWT 以及奈必洛尔对 6MWT 的影响。
SENIORS 试验评估了奈必洛尔与安慰剂对年龄≥70 岁心力衰竭患者的死亡和住院的影响。共有 1982 名患者在基线时和 1716 名患者在 6 个月时进行了 6MWT。患者被分为三分位数（≤200m、201 至≤300m 和>300m）和从基线到 6 个月的步行距离变化（<0m、0 至<30m 和≥30m）。主要终点为全因死亡率和心血管住院。次要终点为全因死亡率。基线步行距离≤200m 的患者发生主要和次要结局的风险更高（HR 1.41，95%CI 1.17-1.69，p<0.001）和（HR 1.37，95%CI 1.05-1.78，p=0.019）。6 个月内步行距离下降与临床事件风险增加相关。奈必洛尔对 6 个月内步行距离的变化没有影响。
6MWT 在老年患者中有预后价值。那些行走距离小于 200m 的患者风险最高。奈必洛尔对 6MWT 没有影响。
