Do repeat 6-minute walk tests provide clinically meaningful information in symptomatic heart failure?
Abstract
Background: Two baseline 6-minute walk tests (6MWTs) have been recommended to mitigate a potential learning effect when assessing exercise performance, but the magnitude of any learning effect in heart failure with reduced ejection fraction (HFrEF) is uncertain. Using the Sildenafil in Heart Failure (SilHF) trial, in which two baseline 6MWTs were performed (screening and inclusion), we assessed a potential learning effect in this population. We also assessed whether choice of baseline test affected associations with longitudinal patient-reported outcomes and compared our findings to reports in the current literature.
Methods and results: In SilHF, 69 patients with HFrEF and evidence of pulmonary hypertension performed 6MWTs at screening and again at study inclusion. Tests were performed no more than two weeks apart on unchanged optimal medical therapy. Only the inclusion 6MWT was used for efficacy evaluation of sildenafil. Screening and inclusion distances were compared using a paired t-test. Additionally, we assessed whether each baseline 6MWT (screening and inclusion) correlated with longitudinal patient-reported outcome measures. Outcomes included the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL-5D visual analogue scale (EQ-5D VAS), assessed at 24 weeks. Although the inclusion 6MWT distance was statistically significantly higher than the screening test (+11.3 m, 95% CI 2.6 to 20.1, p = 0.012), the two baseline tests demonstrated very similar correlation…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 69 participants or records.
Read the paper
Related studies
- 2024 update in heart failure
- Vascular involvement in idiopathic pulmonary fibrosis
- A novel technique- subendometrial autologous platelet rich plasma injection in patients with unresponsive thin endometrium undergoing frozen-thawed embryo transfer: a prospective cohort study
- Does metformin prolong pregnancy in preterm pre-eclampsia? A study protocol for a South African, hospital-based double-blind, randomised, placebo-controlled trial
- Combined Pulmonary Fibrosis and Emphysema (CPFE): A "New" Smoking-Related Interstitial Lung Disease (ILD)
- Impact of an acute 1-month cannabidiol treatment on pain and inflammation after a long bone fracture: a triple-blind randomised, placebo-controlled, clinical trial protocol
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.