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Randomized Controlled Trial
. 2013 Sep 1;112(5):700-6.
doi: 10.1016/j.amjcard.2013.04.046. Epub 2013 May 29.

Relation between six-minute walk test performance and outcomes after transcatheter aortic valve implantation (from the PARTNER trial)

Philip Green  1 , David J Cohen, Philippe Généreux, Tom McAndrew, Suzanne V Arnold, Maria Alu, Nirat Beohar, Charanjit S Rihal, Michael J Mack, Samir Kapadia, Danny Dvir, Mathew S Maurer, Mathew R Williams, Susheel Kodali, Martin B Leon, Ajay J Kirtane
Affiliations
Randomized Controlled Trial

Relation between six-minute walk test performance and outcomes after transcatheter aortic valve implantation (from the PARTNER trial)

Philip Green et al. Am J Cardiol. .

Abstract

Functional capacity as assessed by 6-minute walk test distance (6MWTD) has been shown to predict outcomes in selected cohorts with cardiovascular disease. To evaluate the association between 6MWTD and outcomes after transcatheter aortic valve implantation (TAVI) among participants in the Placement of AoRTic TraNscathetER valve (PARTNER) trial, TAVI recipients (n = 484) were stratified into 3 groups according to baseline 6MWTD: unable to walk (n = 218), slow walkers (n = 133), in whom 6MWTD was below the median (128.5 meters), and fast walkers (n = 133) with 6MWTD >128.5 meters. After TAVI, among fast walkers, follow-up 6MWTD decreased by 44 ± 148 meters at 12 months (p <0.02 compared with baseline). In contrast, among slow walkers, 6MWTD improved after TAVI by 58 ± 126 meters (p <0.001 compared with baseline). Similarly, among those unable to walk, 6MWTD distance increased by 66 ± 109 meters (p <0.001 compared with baseline). There were no differences in 30-day outcomes among 6MWTD groups. At 2 years, the rate of death from any cause was 42.5% in those unable to walk, 31.2% in slow walkers, and 28.8% in fast walkers (p = 0.02), driven primarily by differences in noncardiac death. In conclusion, among high-risk older adults undergoing TAVI, baseline 6MWTD does not predict procedural outcomes but does predict long-term mortality. Nonetheless, patients with poor baseline functional status exhibit the greatest improvement in 6MWTD. Additional work is required to identify those with poor functional status who stand to benefit the most from TAVI.

Trial registration: ClinicalTrials.gov NCT00530894.

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Figures

Figure 1
Figure 1
Distribution of baseline 6-minute walk distance (meters) among 266 participants who were able to perform the baseline 6-minute walk test.
Figure 2
Figure 2
Six-minute walk test distance at baseline, 1 month, 6 months, and 1 year after TAVI. Asterisk (*) indicates overall comparison significant at a level of p <0.001 (analysis of variance) and all pairwise comparisons significant at a level of p <0.05 (Tukey corrected t tests). The number of participants at each time point is indicated over each bar.
Figure 3
Figure 3
(A) Pairwise comparison of 6MWTD (meters) at baseline and 12 months after transcatheter aortic valve implantation among fast walkers. (B) Pairwise comparison of 6MWTD (meters) at baseline and 12 months after TAVI among slow walkers. (C) Pairwise comparison of 6MWTD (meters) at baseline and 12 months after TAVI among those unable to walk.
Figure 4
Figure 4
(A) Kaplan Meier estimates of death stratified by baseline 6MWTD category. (B) Kaplan-Meier estimates of noncardiac death stratified by baseline 6MWTD category. (C) Kaplan-Meier estimates of cardiac death stratified by baseline 6MWTD category.
See this image and copyright information in PMC

References

    1. Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, Fontana GP, Dewey TM, Thourani VH, Pichard AD, Fischbein M, Szeto WY, Lim S, Greason KL, Teirstein PS, Malaisrie SC, Douglas PS, Hahn RT, Whisenant B, Zajarias A, Wang D, Akin JJ, Anderson WN, Leon MB. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med. 2012;366:1686–1695. - PubMed
    1. Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, Thourani VH, Babaliaros VC, Webb JG, Herrmann HC, Bavaria JE, Kodali S, Brown DL, Bowers B, Dewey TM, Svensson LG, Tuzcu M, Moses JW, Williams MR, Siegel RJ, Akin JJ, Anderson WN, Pocock S, Smith CR, Leon MB. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J of Med. 2012;366:1696–1704. - PubMed
    1. Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor DW, Berman LB. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J. 1985;132:919–923. - PMC - PubMed
    1. Cahalin LP, Mathier MA, Semigran MJ, Dec GW, DiSalvo TG. The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure. Chest. 1996;110:325–332. - PubMed
    1. Ross R, Murthy J, Wollak I, Jackson A. The six minute walk test accurately estimates mean peak oxygen uptake. BMC Pulm Med. 2010;10:31–40. - PMC - PubMed

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