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Open AccessFeature PaperArticle

Feasibility of Serial 6-min Walk Tests in Patients with Acute Heart Failure

Department of Emergency Medicine, Vanderbilt University Medical Center and Tennessee Valley Healthcare System, Nashville, TN 37232, USA
Statistical Resources, Inc., Chapel Hill, NC 27514, USA
Department of Emergency Medicine, Henry Ford Health System, Detroit, MI 48126, USA
Department of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, USA
Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
Wake Forest School of Medicine, Winston Salem, NC 27109, USA
Therapeutic Development Consultants LLC
Previously of Cardioxyl Pharmaceuticals, Chapel Hill, NC 27514, USA
Division of Cardiology, University of Colorado School of Medicine and CPC Clinical Research, Aurora, CO 80045, USA
Orchard Biomedical Consulting LLC, Brookline, MA 02446, USA
Department of Emergency Medicine & Indianapolis EMS, Indiana University School of Medicine, Indianapolis, IN 46202, USA
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Lindsay Brown
J. Clin. Med. 2017, 6(9), 84;
Received: 17 August 2017 / Revised: 1 September 2017 / Accepted: 4 September 2017 / Published: 11 September 2017
Background: Functional status assessment is common in many cardiovascular diseases but it has undergone limited study in the setting of acute heart failure (AHF). Accordingly, we performed a pilot study of the feasibility of the six-minute walk test (6MWT) at the emergency department (ED) presentation and through the hospitalization in patients with AHF. Methods and Results: From November 2014 to February 2015, we conducted a multicenter, observational study of ED patients, aged 18–85 years, whose primary ED admission diagnosis was AHF. Other criteria for enrollment included a left ventricular ejection fraction ≤40%, systolic blood pressure between 90 and 170 mmHg, and verbal confirmation that the patient was able to walk >30 m at the baseline, prior to ED presentation. Study teams were uniformly trained to administer a 6MWT. Patients underwent a baseline 6MWT within 24 h of ED presentation (Day 1) and follow-up 6MWTs at 24 (Day 2), 48 (Day 3), and 120 h (Day 5). A total of 46 patients (65.2% male, 73.9% African American) had a day one mean walk distance of 137.3 ± 78 m, day 2 of 170.9 ± 100 m, and day 3 of 180.8 ± 98 m. The 6MWT demonstrated good reproducibility, as the distance walked on the first 6MWT on Day 3 was similar to the distance on the repeated 6MWT the same day. Conclusions: Our pilot study demonstrates the feasibility of the 6MWT as a functional status endpoint in AHF patients. A larger study in a more demographically diverse cohort of patients is necessary to confirm its utility and association with 30-day heart failure (HF) events. View Full-Text
Keywords: 6 min walk test; acute heart failure; emergency department 6 min walk test; acute heart failure; emergency department
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MDPI and ACS Style

Collins, S.P.; Thorn, M.; Nowak, R.M.; Levy, P.D.; Fermann, G.J.; Hiestand, B.C.; Cowart, T.D.; Venuti, R.P.; Hiatt, W.R.; Foo, S.; Pang, P.S. Feasibility of Serial 6-min Walk Tests in Patients with Acute Heart Failure. J. Clin. Med. 2017, 6, 84.

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