| Objective: To determine and investigate the usefulness of the six minute walked distance (6MWD) and its relationship with multiple clinical characteristics and its effectiveness as a predictor of clinical outcomes.;Background: Heart Failure (HF) is a chronic and progressive clinical condition characterized by poor quality of life (QOL), multiple co-morbidities, and a complex therapeutic regimen. A simple noninvasive easy to perform test has the potential to be an efficient way in treating and managing HF patients.;Design: A retrospective observational study of 482 de-identified HF patients with multiple clinical characteristics and health realted quality of life (HRQOL) data. Patients were encouraged to cover as much distance as they could in 6 minutes.;Method: Linear and logistic regression models were used to analyze the data to investigate the usefulness of the 6MWD as a discriminating and predictive indicator in patients with mild to severe HF.;Results: 482 patients studied; 63% males and 37% females, mean (SD) age, 61.36 (14.82) years. 40.7% had multiple co-morbidities and 74.7% were on multiple medications. Patients without co-morbidity (hypertension (HTN), diabetes mellitus (DM), cerebrovascular accident (CVA)/peripheral vascular disease (PVD)), did not have coronary artery bypass grafting (CABG), did not take spironolactone significantly walked further compared to those with. Patients with less disease severity based on (New York Heart Association (NHYA) classification, American College of Cardiology (ACC) staging, left ventricular ejection fraction (LVEF) category, and Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score category) walked further than those with greater disease severity. 6MWD showed an inverse relationship with the exercise BORG scale fatigue (BORGFAT) and BORG scale dyspnea (BORGDYS) scores. 6MWD significantly affected the change of the resting compared to the exercise heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SPB), mean artery blood pressure (MABP), BORGFAT and BORGDYS (p<0.001). 6MWD significantly showed a linear relationship with 8 of 10 KCCQ domain scores and was a strong independent predictor of HTN, DM, CVA/PVD, CABG, LVEF<45%, disease severity (NYHA and ACC), disease etiology severity (LVEF), HRQOL severity (KCCQ overall score).;Conclusion: The 6 minute walk test (6MWT) is a noninvasive tool for risk-stratification of patients with HF that can aid to personalize their treatment. 6MWD significantly discriminated between patients with or without co-morbidity and also differentiated between the severity of the conditions (NHYA, ACC, LVEF, and KCCQ overall score). 6MWD was shown to be a strong predictor of HTN, DM, CVA//PVD, CAD intervention, HRQOL, disease severity, and disease etiology severity. 6MWD shown to be a usefull tool to assess HRQOL. |
