Qu Jiangbo, Shi Hui, Guo Yugong, Chen Xinxin, Xiao Xuwen, Zheng Xiaojuan, Cui Yanqin
Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Front Pediatr. 2022 Nov 14;10:965739. doi: 10.3389/fped.2022.965739. eCollection 2022.
We aimed to assess the validity of the six-minute walk test (6MWT) to reflect the functional capacity of children with congenital heart disease (CHD), evaluate a possible correlation between the 6MWT distance with cardiopulmonary exercise test (CPET) variables, as well as to find a cutoff value to stratification the physical fitness in this population.
We enrolled 459 children with CHD, 6-18 years old, who performed a complete CPET and 6MWT on the same day in a cross-sectional observational study. Correlations between variables of CPET and six-minute walking distance (6MWD) were analyzed and cutoff values of 6MWD were identified for the classification of the physical fitness in the population.
The mean distance ambulated during the 6MWT was 578 ± 65 m, 590 ± 65 m for boys, and 562 ± 62 m for girls ( < 0.001). Both VO and %predicted VO showed a correlation with the 6MWT distance ( = 0.35, < 0.001 and = 0.51, < 0.001, respectively), and an inverse correlation was found between VE/VCO2 slope and the 6MWT distance ( = -0.31; < 0.001). There appeared to be a linear association between 6MWD and VO up to a 6MWD of approximately 600 m. We divided the population into 4 subgroups (boys <130 cm; boys ≥130 cm; girls <130 cm; girls ≥130 cm), and get the cutoff values (554 m, 617 m, 549 m, 587 m) respectively equivalent to 80% of predicted VO. The 6MWT distances of another 102 patients were applied for external verification of the cutoff values.
Our study provided evidence on when a 6MWT should be considered as a convincing complementary test in the pediatric population with CHD and explored the classification of exercise tolerance using a 6MWD value. The cut-off values for 6MWD may be qualified as an intervention target for exercise rehabilitation.
我们旨在评估六分钟步行试验（6MWT）反映先天性心脏病（CHD）患儿功能能力的有效性，评估6MWT步行距离与心肺运动试验（CPET）变量之间的可能相关性，并找到一个用于对该人群体能进行分层的临界值。
在一项横断面观察性研究中，我们纳入了459名6至18岁的CHD患儿，他们在同一天进行了完整的CPET和6MWT。分析了CPET变量与六分钟步行距离（6MWD）之间的相关性，并确定了6MWD的临界值用于该人群体能的分类。
6MWT期间的平均步行距离为578±65米，男孩为590±65米，女孩为562±62米（P<0.001）。VO₂和预测VO₂百分比均与6MWT距离相关（分别为r = 0.35，P<0.001和r = 0.51，P<0.001），并且VE/VCO₂斜率与6MWT距离呈负相关（r = -0.31；P<0.001）。在6MWD约为600米之前，6MWD与VO₂之间似乎存在线性关联。我们将人群分为4个亚组（男孩<130厘米；男孩≥130厘米；女孩<130厘米；女孩≥130厘米），并分别获得了相当于预测VO₂ 80%的临界值（554米、617米、549米、587米）。另外102名患者的6MWT距离用于临界值的外部验证。
我们的研究提供了关于何时应将6MWT视为CHD儿科人群中令人信服的补充试验的证据，并探索了使用6MWD值对运动耐力进行分类。6MWD的临界值可作为运动康复的干预目标。
