PREDICTIVE VALUE OF MORTALITY AND HOSPITALIZATION OF THE 6-MINUTE WALK TEST IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION

Thị Thu Hoài Nguyễn1,2,, Thành Chung Chăng3
1 Bach Mai hopsital
2 VNU Hanoi-University of Medicine and Pharmacy
3 Lang Son Medical College

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Abstract

Aims: To study the predictive value of mortality and hospitalization of the 6-minute walk test in patients with heart failure with reduced ejection fraction. Methods: Patients with chronic heart failure who had reduced ejection fraction (HFrEF) admitted to the hospital were included in the study. Data of medical history, clinical examinnation biochemical tests, echocardiography were collected. All patients had a 6-minute walking test (6MWT), 6-minute walking distance measurement (6MWD) and were monitored for mortality and re-hospitalization during 6 months after discharge. COX regression model was used to investigate the relation between the 6-minute walk test and some other prognostic factors in heart failure with the composite of death and re - hospitalization. Results: During the period from September 2020 to October 2021, there were 104 HFrEF patients with an average age of 65.87 ± 14.77, 67.3% male, 32.7% female were included in the study. The rate of death and re-hospitalization after discharge within 6 months of study subjects was 53.8%. 6MWD with the optimal cut off point found to be 290m, the sensitivity was 71.4%, the specificity was 75%, the area under the curve (AUC) ROC was 0.7321 with p < 0.05, respectively. Thus, 6MWD < 290 m had a good prognostic value of mortality and re-hospitalization for patients with chronic heart failure with EF < 40%. The 6-minute walk test had a better predictive value in mortality and rehospitalization in patients with HFrEF compared to left ventricular diastolic diameter, left atrial diameter, and plasma NT- proBNP and hs-TroponinT levels.  Conclusion: The 6-minute walk test is one of the simple and easy-to-implement tests to assess the severity of heart failure with reduced left ventricular ejection fraction. It can be recommended in clinical practice.

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References

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