Jin Junhao, Mi Yao, Wang Aqian, Li Bo, Jiang Kaiyu, Zhu Hai, Liang Ting, Su Hongling, Cao Yunshan
The First School of Clinical Medicine, Lanzhou University Lanzhou China.
Department of Cardiology Pulmonary Vascular Disease Center, Gansu Provincial Hospital Lanzhou China.
Pulm Circ. 2025 Apr 24;15(2):e70087. doi: 10.1002/pul2.70087. eCollection 2025 Apr.
The 6-min walk test (6MWT) has significant prognostic value, but requires long walking distances and lacks evaluation of exercise speed. This study aimed to investigate the clinical utility of a new walk test, the 18-meter walk test (18MWT), in patients with pulmonary arterial hypertension (PAH) as a complement to the 6MWT. In summary, a total of 117 patients with PAH from January 2018 to December 2022 were included. Spearman correlation, Cox regression, and Kaplan-Meier analysis were utilized to demonstrate the value of 18MWT in predicting disease severity and clinical worsening. The median time to complete the 18MWT was 12.8 s (interquartile range: 11.3-14.6 s). 18MWT completion time showed significant correlations with indicators such as N-terminal pro-brain natriuretic peptide and 6MWT distance. Adjusted Cox regression showed 18MWT time remained an independent predictor of clinical worsening (hazard ratio = 1.10; 95% confidence interval: 1.01-1.21; = 0.026). A simplified risk stratification using WHO functional class, 6MWT distance, 18MWT time and NT-proBNP was predictive of 1-year clinical outcome. These results suggest that the 18MWT provides clinicians with an efficient measure that can be used to evaluate the disease severity of PAH patients and to identify those patients at greater risk for future clinical worsening as a complement to the 6MWT.
6分钟步行试验（6MWT）具有显著的预后价值，但需要较长的步行距离且缺乏对运动速度的评估。本研究旨在探讨一种新的步行试验——18米步行试验（18MWT）在肺动脉高压（PAH）患者中的临床应用价值，作为6MWT的补充。总之，纳入了2018年1月至2022年12月期间共117例PAH患者。采用Spearman相关性分析、Cox回归分析和Kaplan-Meier分析来证明18MWT在预测疾病严重程度和临床恶化方面的价值。完成18MWT的中位时间为12.8秒（四分位间距：11.3 - 14.6秒）。18MWT完成时间与N末端脑钠肽前体和6MWT距离等指标显示出显著相关性。调整后的Cox回归分析显示，18MWT时间仍然是临床恶化的独立预测因素（风险比 = 1.10；95%置信区间：1.01 - 1.21；P = 0.026）。使用世界卫生组织功能分级、6MWT距离、18MWT时间和NT-proBNP进行的简化风险分层可预测1年临床结局。这些结果表明，18MWT为临床医生提供了一种有效的测量方法，可用于评估PAH患者的疾病严重程度，并识别那些未来临床恶化风险较高的患者，作为6MWT的补充。
