Prognostic Usefulness of the 6-Minute Walk Test in Patients With Severe Aortic Stenosis

Autor: Leticia Jaulent-Huertas, Luciano Consuegra-Sánchez, José A. Giner-Caro, Ramón Rubio-Patón, Miryam Martínez-Pascual-de-Riquelme, Juan Antonio Castillo-Moreno, Juan Carlos Bonaque-González, Derek F. Dau-Villarreal, Irene A. García-Escribano
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Walk Test
Comorbidity
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Doppler echocardiography
Conservative Treatment
Severity of Illness Index
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
Cause of Death
Atrial Fibrillation
medicine
Humans
030212 general & internal medicine
Prospective Studies
Mortality
Prospective cohort study
Cause of death
Aged
Proportional Hazards Models
Aged
80 and over
Heart Failure
Univariate analysis
medicine.diagnostic_test
business.industry
Atrial fibrillation
Stroke Volume
Aortic Valve Stenosis
medicine.disease
Prognosis
Echocardiography
Doppler
Surgery
Hospitalization
Stenosis
ROC Curve
Aortic valve stenosis
Heart failure
Asymptomatic Diseases
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: The American journal of cardiology. 118(8)
ISSN: 1879-1913
Popis: The 6-minute walk test distance (6MWD) has been shown to predict prognosis in selected cohorts of patients with heart failure and outcomes after surgical or transcatheter aortic valve implantation (AVI) in patients with symptomatic severe aortic stenosis (AS). Our objective was to evaluate the association between the 6MWD and outcome in patients with severe AS while remaining under medical treatment. In a prospective observational cohort study, a total of 149 patients diagnosed with severe AS by Doppler echocardiography underwent a 6-minute walk test. The single end point was a composite of all-cause death or hospitalization for heart failure. Patients receiving an AVI were censored from follow-up at the time of their AVI, so that only the events that occurred while the patients remained under medical treatment were included in the analysis. During follow-up (median 12.9 months), the end point occurred in 65 patients (43.6%). Univariate analysis showed an association between the 6MWD and the end point (p0.001). After adjustment for symptoms, left ventricular ejection fraction, aortic valve area, Charlson co-morbidity score, and anemia, the 6MWD independently predicted the end point (adjusted hazard ratio 0.63; 95% confidence interval 0.45 to 0.89; p = 0.010). The incidence of the composite end point was 12 per 100 patient-years in patients with a 6MWD331 m compared to 86 per 100 patient-years in those with a 6MWD ≤331 m (p0.001). In conclusion, although patients with severe AS remain under medical treatment, the 6MWD is independently associated with all-cause death or hospitalization for heart failure.
Databáze: OpenAIRE
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