Saito Hiroshi, Maeda Daichi, Kagiyama Nobuyuki, Sunayama Tsutomu, Dotare Taishi, Fujimoto Yudai, Nakade Taisuke, Jujo Kentaro, Saito Kazuya, Kamiya Kentaro, Ogasahara Yuki, Maekawa Emi, Konishi Masaaki, Kitai Takeshi, Iwata Kentaro, Wada Hiroshi, Kasai Takatoshi, Nagamatsu Hirofumi, Momomura Shin-Ichi, Matsue Yuya
Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan.
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Eur J Prev Cardiol. 2024 Dec 4;31(17):2036-2043. doi: 10.1093/eurjpc/zwae291.
The 6-min walk test (6MWT) is a widely accepted tool for evaluating exercise tolerance and physical capacity, and the 6-min walk distance (6MWD) is an established prognostic factor in patients with heart failure (HF). However, the prognostic implications of post-6MWT dyspnoea remain unknown. We aimed to investigate the prognostic value of Borg scores after the 6MWT in patients with HF.
Patients hospitalized for HF who underwent the 6MWT before discharge were included. Post-test dyspnoea was assessed using the Borg scale. Patients were stratified into low and high Borg score groups based on the median Borg score. The primary outcome was 2-year mortality. Among 1185 patients analysed, the median Borg score was 12. The 6MWD was significantly shorter in the high Borg score group than in the low Borg score group. The 2-year mortality rate was 20.2%. In the Kaplan-Meier analysis, the high Borg score group demonstrated an association with 2-year mortality, which remained significant even after adjustment for conventional risk factors, including the 6MWD. Furthermore, the Borg scale provided significant net reclassification improvement to the conventional risk model incorporating 6MWD.
In hospitalized patients with HF, post-6MWT Borg scores were associated with 2-year mortality independent of the 6MWD, providing incremental prognostic value to the 6MWD. Even if patients are able to walk long distances for 6 min, it is essential to closely observe dyspnoea immediately thereafter.
6分钟步行试验（6MWT）是评估运动耐量和身体能力的一种广泛接受的工具，6分钟步行距离（6MWD）是心力衰竭（HF）患者既定的预后因素。然而，6MWT后呼吸困难的预后意义仍不明确。我们旨在研究HF患者6MWT后Borg评分的预后价值。
纳入出院前接受6MWT的HF住院患者。使用Borg量表评估试验后呼吸困难情况。根据Borg评分中位数将患者分为低Borg评分组和高Borg评分组。主要结局是2年死亡率。在分析的1185例患者中，Borg评分中位数为12。高Borg评分组的6MWD明显短于低Borg评分组。2年死亡率为20.2%。在Kaplan-Meier分析中，高Borg评分组显示与2年死亡率相关，即使在调整包括6MWD在内的传统危险因素后仍具有显著性。此外，Borg量表对纳入6MWD的传统风险模型有显著的净重新分类改善。
在HF住院患者中，6MWT后Borg评分与2年死亡率相关，独立于6MWD，为6MWD提供了额外的预后价值。即使患者能够在6分钟内行走较长距离，此后也必须密切观察呼吸困难情况。
