Title |
The 6MWT as a prognostic tool in pulmonary arterial hypertension: results from the COMPERA registry
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Published in |
Clinical Research in Cardiology, January 2018
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DOI | 10.1007/s00392-018-1207-5 |
Pubmed ID | |
Authors |
Thomas A. Zelniker, Dörte Huscher, Anton Vonk-Noordegraaf, Ralf Ewert, Tobias J. Lange, Hans Klose, Daniel Dumitrescu, Michael Halank, Matthis Held, Henning Gall, David Pittrow, Marius M. Hoeper, Lutz Frankenstein |
Abstract |
In patients with pulmonary arterial hypertension, the 6-Minute Walk Test (6MWT) is recommended for risk stratification and follow-up by all guidelines. However, the prognostic value of the 6MWT has been discussed controversially. We sought to compare and validate all published 6MWT cut-off points. From the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA)-registry we identified 2391 patients with pulmonary arterial hypertension who had at least one documented 6MWT measurement. A Medline search identified a total of 21 different threshold values for either single-point or change of 6MWT. All values were tested individually for prognostication of 1-year, 2-year and 3-year all-cause mortality. The highest positive likelihood ratio was a cut-off value < 165 ms, whereas the best negative likelihood ratio was found to be a threshold of 440 ms. Furthermore, improvement in 6MWT had considerably less predictive value on mortality and survival than deterioration. Moreover, absolute single-point values outperformed change values for both improvement and worsening. Our data confirmed the prognostic relevance of the 6MWT and support the cut-off values stated in most recent guidelines. Furthermore, these results explain why changes in 6MWT did not correlate consistently with prognosis in previous studies. |
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Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
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