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. 2025 Sep;114(9):1098-1108.
doi: 10.1007/s00392-023-02373-3. Epub 2024 Jan 18.

Determinants and reference values of the 6-min walk distance in the general population-results of the population-based STAAB cohort study

Caroline Morbach  1   2 , Nicola Moser  3 , Vladimir Cejka  3   4 , Michael Stach  5 , Floran Sahiti  3   4 , Fabian Kerwagen  3   4 , Stefan Frantz  3   4 , Rüdiger Pryss  5 , Götz Gelbrich  3   5   6 , Peter U Heuschmann #  3   5   6 , Stefan Störk #  3   4 ; STAAB consortium
Collaborators, Affiliations

Determinants and reference values of the 6-min walk distance in the general population-results of the population-based STAAB cohort study

Caroline Morbach et al. Clin Res Cardiol. 2025 Sep.

Abstract

Aims: The 6-min walk test is an inexpensive, safe, and easy tool to assess functional capacity in patients with cardiopulmonary diseases including heart failure (HF). There is a lack of reference values, which are a prerequisite for the interpretation of test results in patients. Furthermore, determinants independent of the respective disease need to be considered when interpreting the 6-min walk distance (6MWD).

Methods: The prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigates a representative sample of residents of the City of Würzburg, Germany, aged 30 to 79 years, without a history of HF. Participants underwent detailed clinical and echocardiographic phenotyping as well as a standardized assessment of the 6MWD using a 15-m hallway.

Results: In a sample of 2762 participants (51% women, mean age 58 ± 11 years), we identified age and height, but not sex, as determinants of the 6MWD. While a worse metabolic profile showed a negative association with the 6MWD, a better systolic and diastolic function showed a positive association with 6MWD. From a subgroup of 681 individuals without any cardiovascular risk factors (60% women, mean age 52 ± 10 years), we computed age- and height-specific reference percentiles.

Conclusion: In a representative sample of the general population free from HF, we identified determinants of the 6MWD implying objective physical fitness associated with metabolic health as well as with cardiac structure and function. Furthermore, we derived reference percentiles applicable when using a 15-m hallway.

Keywords: Cardiopulmonary exercise capacity; Functional capacity; Normal values; Online calculator; Physical fitness; Six-minute walk test.

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Conflict of interest statement

Declarations. Conflict of interest: C.M. reports research cooperation with the University of Würzburg and Tomtec Imaging Systems funded by a research grant from the Bavarian Ministry of Economic Affairs, Regional Development and Energy, Germany; she is supported by the German Research Foundation (DFG) within the Comprehensive Research Center 1525 “Cardio-immune interfaces” (453989101, project C5) and receives financial support from the Interdisciplinary Center for Clinical Research—IZKF Würzburg (advanced clinician-scientist program; AdvCSP 3). She further received advisory and speakers honoraria as well as travel grants from Tomtec, Alnylam, AKCEA, Pfizer, Boehringer Ingelheim, SOBI, AstraZeneca, NovoNordisk, Alexion, Janssen, and EBR Systems; principal investigator in trials sponsored by Alnylam, Bayer, NovoNordisk, and AstraZeneca. N.M. has no conflicts of interest regarding the present work. V.C. has no conflicts of interest regarding the present work. M.S. has no conflicts of interest regarding the present work. F.S. has no conflicts of interest regarding the present work. F.K. has no conflicts of interest regarding the present work. S.F. has no conflicts of interest regarding the present work. R.P. has no conflicts of interest regarding the present work. G.G. reports research cooperation with the University Hospital Würzburg and Tomtec Imaging Systems funded by a research grant from the Bavarian Ministry of Economic Affairs, Regional Development and Energy, Germany. PU. H. has no conflicts of interest regarding the present work. S.S. is supported by the CHFC Würzburg, and by the German Federal Ministry of Education and Research (BMBF). He has received consultancy and lecture fees from AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Pfizer, and Servier.

Figures

Fig. 1
Fig. 1
Study consort. STAAB, population-based Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression Cohort Study; 6MWT, 6-min walk test; 6MWD, 6-min walk distance; BP, blood pressure
See this image and copyright information in PMC

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