Abstract 18053: Six Minute Walk Test and Outcomes in Stable Outpatients with Heart Failure: The Atlanta Cardiomyopathy Consortium
Background: Reduced exercise capacity in cardiopulmonary exercise testing strongly predicts outcomes in HF. The 6-minute walk test (6MWT) is a simpler alternative to assess exercise capacity. Data on the association of 6MWT performance with health care resource utilization are limited for stable HF patients on contemporary optimal therapy.
Methods: We evaluated 286 ambulatory patients enrolled between Jan 2008 and July 2011 in a HF cohort study in the metro Atlanta area who were able to perform a 6MWT at baseline. Using count-data models, we examined the association of 6MWT distance with (1) rates of health care resource utilization (HF and all-cause admissions, emergency department [ED] visits, and days in hospital) and (2) major clinical events (death, urgent transplantation, ventricular assist device [VAD] implantation).
Results: Patient characteristics are presented in Table 1. Mean 6MWT distance was 353±107 m. After a median of 3.2 years (2.0 to 3.9), there were 49 major clinical events (death: 38; transplantation: 5; VAD: 6), 753 all-cause admissions, 268 HF admissions, and 386 ED visits. Patients with a 6MWT distance <350m had a higher rate of all-cause and HF admissions and ED visits, and spent more days in the hospital, compared to those with 6MWT ≥350m after adjusting for demographics, etiology, ejection fraction, sodium, renal function, and HF treatment (Table 2). Reduced 6MWT was also associated with a trend for more clinical events (hazard ratio: 1.77; 95% CI: 0.93 to 3.35; P=0.082) in adjusted models.
Conclusion: In HF patients on contemporary optimal therapy, reduced performance on a 6MWT is associated with increased rates of health care resource utilization.
- © 2012 by American Heart Association, Inc.