Universität zu Köln

Zelniker, Thomas A., Huscher, Doerte, Vonk-Noordegraaf, Anton, Ewert, Ralf, Lange, Tobias J., Klose, Hans, Dumitrescu, Daniel, Halank, Michael, Held, Matthis, Gall, Henning, Pittrow, David, Hoeper, Marius M. and Frankenstein, Lutz (2018). The 6MWT as a prognostic tool in pulmonary arterial hypertension: results from the COMPERA registry. Clin. Res. Cardiol., 107 (6). S. 460 - 471. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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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:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zelniker, Thomas A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huscher, Doerte UNSPECIFIED UNSPECIFIED UNSPECIFIED Vonk-Noordegraaf, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Ewert, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, Tobias J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klose, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Halank, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Held, Matthis UNSPECIFIED UNSPECIFIED UNSPECIFIED Gall, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Pittrow, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoeper, Marius M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Frankenstein, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-185631
DOI:	10.1007/s00392-018-1207-5
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	107
Number:	6
Page Range:	S. 460 - 471
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 6-MINUTE WALK DISTANCE; DISEASE MANAGEMENT REVEAL; IMPORTANT DIFFERENCE; PREDICTIVE-VALUE; HEART-FAILURE; THERAPY; TRIALS; GUIDELINES; DIAGNOSIS; SURVIVAL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18563