Zelniker, Thomas A. and Huscher, Doerte and Vonk-Noordegraaf, Anton and Ewert, Ralf and Lange, Tobias J. and Klose, Hans and Dumitrescu, Daniel and Halank, Michael and Held, Matthis and Gall, Henning and Pittrow, David and Hoeper, Marius M. and Frankenstein, Lutz (2018) The 6MWT as a prognostic tool in pulmonary arterial hypertension: results from the COMPERA registry. CLINICAL RESEARCH IN CARDIOLOGY, 107 (6). pp. 460-470. ISSN 1861-0684, 1861-0692
Full text not available from this repository. (Request a copy)Abstract
Background 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. Methods 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. Results 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. Conclusion 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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 6-MINUTE WALK DISTANCE; DISEASE MANAGEMENT REVEAL; IMPORTANT DIFFERENCE; PREDICTIVE-VALUE; HEART-FAILURE; THERAPY; TRIALS; GUIDELINES; DIAGNOSIS; SURVIVAL; Pulmonary arterial hypertension; PAH; 6-Minute walk test; Risk stratification; Cut-off value |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Mar 2020 13:46 |
| Last Modified: | 10 Mar 2020 13:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14536 |
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