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  • Title: Diagnostic value of the six-minute walk test (6MWT) in grown-up congenital heart disease (GUCH): Comparison with clinical status and functional exercise capacity.
    Author: Kehmeier ES, Sommer MH, Galonska A, Zeus T, Verde P, Kelm M.
    Journal: Int J Cardiol; 2016 Jan 15; 203():90-7. PubMed ID: 26498869.
    Abstract:
    BACKGROUND: Exercise testing for the assessment of functional capacity plays an important role in long-term follow-up of GUCH patients. CPX is the favored modality for decision-making recommended in the current guidelines. In contrast to this complex method, the 6 MWT is a simple, easy-to-perform, safe, and commonly available exercise test. Although well-established in various cardiopulmonary diseases, the diagnostic impact of the 6 MWT in GUCH patients is not known so far. METHODS: 102 GUCH patients were evaluated by 6 MWT and CPX simultaneously. Clinical symptoms were assessed, according to the NYHA classification. Additionally, an echocardiography study, and selected cardiac blood tests (N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive Troponin T) were performed. RESULTS: Ranges of six-minute walk distance (6 MWD) and peak oxygen consumption (peakVO2) were 116-765 m and 6.4-36.2 ml/kg/min, respectively. 6 MWD and peakVO2 showed a close correlation (r=0.72, 95% CI, 0.63 to 0.79). Patients with a peakVO2 of ≤ 15.5 ml/kg/min were excellently identified by 6 MWT (c-value=0.82). A cut-off value of 482 m was optimal to predict reduced peakVO2. In multivariate regression analysis, 6 MWD and NYHA class were identified as relevant predictors of peakVO2. In subgroup analysis, Eisenmenger patients achieved the shortest 6 MWD (280, SD 178 m). CONCLUSION: In our study population of GUCH patients, the 6 MWD shows a close correlation to peakVO2, and an excellent prediction of reduced peakVO2. Thus, it seems to be an easy-to-perform and reliable screening parameter to evaluate functional capacity of these patients (Controlled Clinical Trials number, NCT02193243).
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