The Six-Minute Walk Test Predicts Peak Oxygen Uptake and Survival in Patients With Advanced Heart Failure

¹ From the Massachusetts General Hospital Physical Therapy Services and Heart Failure Center, Harvard Medical School, Boston

Background: The 6-min walk test (6'WT) is a simple measure of functional capacity and predicts survival in patients with moderate heart failure (HF).

Methods: To assess the role of the 6'WT in the evaluation of patients with advanced HF, 45 patients (age 49±8 years, mean±SD; New York Heart Association class 3.3±0.6; left ventricular ejection fraction 0.20±0.06; right ventricular ejection fraction 0.31±0.11) underwent symptom-limited cardiopulmonary exercise testing and the 6'WT during cardiac transplant evaluation.

Results: Mean 6'WT distance ambulated was 310±100 m and peak oxygen uptake (peak Vo₂) was 12.2±4.5 mL/kg/min. There was a significant correlation between 6'WT distance ambulated and peak Vo₂ (r=0.64, p<0.001). Multivariate analysis of patient characteristics, resting hemodynamics, and 6'WT results identified the distance ambulated during the 6'WT as the strongest predictor of peak Vo₂ (p<0.001). 6'WT distance ambulated less than 300 m predicted an increased likelihood of death or pretransplant hospital admission for continuous inotropic or mechanical support within 6 months (p=0.04), but did not predict long-term overall or event-free survival with a mean follow-up of 62 weeks. Peak Vo₂ was the best predictor of long-term overall and event-free survival.

Conclusions: In patients with advanced HF evaluated for cardiac transplantation, distance ambulated during the 6'WT predicts (1) peak Vo₂ and (2) short-term event-free survival.

Key Words: cardiac transplantation • cardiopulmonary exercise testing • heart failure • 6-min walk test

Submitted on August 9, 1995
Accepted on December 12, 2007

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