Abstract 2383: Six Minute Walk Test Predicts Long-Term All-Cause Mortality and Heart Failure Rehospitalization in African American Patients Hospitalized with Acute Decompensated Heart Failure
We prospectively evaluated the usefulness of the 6-minute walk test (6MWT) in predicting mortality and heart failure (HF) rehospitalization in African American (AA) patients with acute decompensated HF. The prognostic value of the 6MWT has been described in patients with HF; however limited data is available in AA population. Two hundred AA patients (63.1% men, mean age 55.7 ± 12.9 y) with acute decompensated HF were prospectively studied. Patients were followed to assess 40-month all-cause mortality and 18-month HF rehospitalization. The median distance walked on the 6MWT was 213 m. Sixty patients (29.8%) died and 114 (59.7%) were rehospitalization for worsening HF. For patients who walked ≤ 200 m during the 6MWT, mortality was 41% compared with 19% in patients who walked > 200 m (P = 0.001), and HF rehospitalization was 68% compared with 52% in those who walked > 200 m (P = 0.027). With univariate analysis, 6MWT distance ≤ 200 m was the strongest predictor of mortality (P = 0.001). Atrial fibrillation (P = 0.005), renal dysfunction (P = 0.003), age (P = 0.024), and New York Heart Association (NYHA) class IV (P = 0.055) were related to survival. Multivariate Cox regression analysis showed that 6MWT distance ≤ 200 m was the strongest predictor of mortality (adjusted hazard ratio [HR], 2.14; confidence interval [CI], 1.20 –3.81; P = 0.01) and HF rehospitalization (adjusted HR, 1.62; CI, 1.10 –2.39; P = 0.015). In AA patients hospitalized with acute decompensated HF, the distance walked ≤ 200 m on the 6MWT is strongly and independently predictive of long-term all-cause mortality and HF rehospitalization.