Six-minute Walk Test For Assessment Of Vulnerable Conditions In Acute Heart Failure

Objectives: To explore the predictive efficacy of the six-minute walk test in the assessment of vulnerable state of heart failure in patients with acute heart failure and acute exacerbation of chronic heart failureMethods: A total of 271 patients with acute heart failure and acute exacerbation of chronic heart failure admitted to our Department of Cardiology from March 2017 to January 2018 were enrolled.Collect basic information(age,height,weight,etc.),medical history,physical examination,venous blood sampling immediately after admission,detect renal function,blood uric acid,NT-proBNP level,heart ultrasound detection of LVEF when the condition is stable,measure 6 minutes walk Test distance.The two groups were divided into two groups:(1)divided into three groups according to the six-minute walking test distance,less than 150 m for the A1 group,150-450 m for the A2 group,and greater than 450 m for the A3 group;(2)according to the serum NT-proBNP level,According to the quartile method,they were divided into 4 groups,313-4402pg/ml for B1 group,4443-7540pg/ml for B2 group,7599-14350pg/ml for B3 group,and 14350-35000pg/ml for B4 group.All enrolled patients were interviewed or telephoned in March after discharge,and the patient's adverse events(re-hospitalization due to heart failure and all-cause death)were recorded.Results:1)There were no significant differences in gender,age,height,BMI,blood pressure,renal function,urea,and uric acid between the A1-A3 groups.There was a statistically significant difference in LVEF between the three groups.The LVEF value of the six-minute walking test distance was less than 150 m.Patients below 150 meters;the smaller the distance between the three groups in the six-minute walking test,the lower the heart failure during the period of heart failure,the higher the mortality rate due to heart failure.2)There were no significant differences in gender,age,height,BMI and blood pressure between the B1-B4 groups.There were significant differences in creatinine,urea nitrogen,blood uric acid and LVEF between the four groups.The higher the serum NT-proBNP,the lower the LVEF value.Patients with NT-proBNP level less than 4402pg/ml had creatinine,urea nitrogen,and blood uric acid levels,which were significantly lower than those with NT-proBNP level greater than 4402pg/ml.The higher the serum NT-proBNP among the four groups,the heart failure during the heart failure Depletion re-admission and all-cause mortality.3)Logistic regression analysis was performed on the distance between the six-minute walking test and the serum NT-proBNP level.The results showed that the distance from the six-minute walk test,serum NT-proBNP level and heart failure were re-admitted to heart failure and all-cause mortality.Obviously related,both are independent risk factors affecting the vulnerable condition of acute heart failure.4)According to the ROC curve area,the six-minute walking test distance and serum NT-proBNP levels have predictive effects on the acute adverse events of acute heart failure,and the six-minute walking test distance is more effective than the serum NT-proBNP level.5)According to the KM survival curve,the shorter the distance of the six-minute walking test,the higher the serum NT-proBNP level,the greater the probability of adverse events in the vulnerable period of acute heart failure,and the shorter the corresponding survival time.Conclusions:The six-minute walking test distance,like serum NT-proBNP,can be used as an independent predictor of disease assessment in patients with vulnerable heart failure.