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首页> 外文期刊>The American Journal of Cardiology >Utility of 6-Minute Walk Test to Predict Response to Cardiac Resynchronization Therapy in Patients With Mild Heart Failure
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Utility of 6-Minute Walk Test to Predict Response to Cardiac Resynchronization Therapy in Patients With Mild Heart Failure

机译：6分钟步行检测预测心脏病患者心脏再同步治疗的反应

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Clinical studies of heart failure (HF) generally utilize the 6-minute walk test (6MWT) for functional capacity (FC) assessment. However, data on the impact of cardiac resynchronization therapy (CRT) on 6MWT and its role to predict long-term outcomes in mild HF patients with CRT are lacking. We studied 1,381 subjects with mild HF enrolled in Multicenter Automatic Defibrillator Implantation Trial Cardiac Resynchronization Therapy with 6MWT data at baseline and 1 year. We assessed the effects of CRT-D on percent change in 6MWT at 1 year by left bundle branch block (LBBB) status, identified independent predictors of 6MWT at 1 year, and evaluated the association between changes in 6MWT and risk for HF or death. Treatment with CRT-D versus implantable cardiac defibrillator (ICD) was not associated with a significant improvement in 6MWT at 1-year in LBBB subjects (2.2 % vs 0.0%, p = 0.428, but it was associated with a deterioration in 6MWT in non-LBBB subjects (4.1% vs 0.0%, p = 0.308). Multivariate analysis showed that each 5% reduction in 6MWT was independently associated with a corresponding 3% increase in the risk of subsequent HF or death (p = 0.014). In conclusion, our findings suggest that 6MWT has limited utility to identify CRT response in mild HF subjects with LBBB. However, 6MWT showed a signal toward deterioration in mild HF subjects with non-LBBB, and this was predictive of subsequent increased risk of HF or death. (C) 2020 Elsevier Inc. All rights reserved.
机译：心力衰竭（HF）的临床研究通常使用6分钟步行试验（6MWT）评估功能能力（FC）。然而，关于心脏再同步化治疗（CRT）对6MWT的影响及其在预测CRT轻度心衰患者长期预后中的作用的数据尚缺乏。我们研究了1381名轻度心衰受试者，他们参加了多中心自动除颤器植入试验心脏再同步治疗，在基线和1年时有6MWT数据。我们评估了CRT-D对左束支传导阻滞（LBBB）状态下1年时6MWT百分比变化的影响，确定了1年时6MWT的独立预测因子，并评估了6MWT变化与心力衰竭或死亡风险之间的关联。在LBBB受试者中，CRT-D与植入式心脏除颤器（ICD）治疗与1年时6MWT的显著改善无关（2.2%与0.0%，p=0.428），但与非LBBB受试者6MWT的恶化相关（4.1%与0.0%，p=0.308）。多变量分析显示，6MWT每减少5%，相应的后续HF或死亡风险就会增加3%（p=0.014）。总之，我们的研究结果表明，6MWT在识别伴有LBBB的轻度HF受试者的CRT反应方面的作用有限。然而，6MWT显示轻度HF受试者（非LBBB）病情恶化的信号，这是随后HF或死亡风险增加的预测。（C） 2020爱思唯尔公司版权所有。

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    Rosero Spencer Z.; Hernandez Natalia; Goldenberg Ilan; McNitt Scott; Plonsky Bronislava; Zareba Wojciech; Buber Yonathan; Solomon Scott D.; Kutyifa Valentina;

  • 作者单位

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

    Univ Washington Med Ctr Cardiol Div Seattle WA 98195 USA;

    Harvard Med Sch Brigham &

    Womens Hosp Cardiol Div Boston MA 02115 USA;

    Univ Rochester Clin Cardiovasc Res Ctr Med Ctr 265 Crittenden Blvd Box 653 Rochester NY 14642;

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  • 正文语种 eng
  • 中图分类 心脏、血管（循环系）疾病;
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