The 6-minute walk test predicts clinical outcome in Asian patients with chronic congestive heart failure on contemporary medical therapy: A study of the multiracial population in Singapore

Background We sought the value of the 6-min walk test (6MWT) in predicting morbidity and mortality in Asian patients with congestive heart failure (CHF). Methods 668 patients (Age 66 ± 12 years, Ejection fraction 29 ± 13%, NYHA I to IV) were prospectively followed up for 36 ± 12 months. 386 patients (58%) took the 6MWT. Cardiac events, defined as the composite end-point of death or CHF readmission were documented. Results 188 patients (28%) reached the composite end-point (63 deaths, 125 readmissions). 6MWT distance was an independent predictor of cardiac events (quartile 1 vs quartile 4)(p = 0.041), as were beta-blocker or spironolactone use (p = 0.008 for both), diabetes (p = 0.042), monthly income less than SGD$1000 (p = 0.030), and NYHA class (class III vs class I)(p = 0.003). A 6MWT distance < 340 m predicted occurrence of cardiac events with a sensitivity of 69% and specificity of 48%. Conclusions The 6MWT is a safe and simple clinical tool, which could predict both morbidity and mortality in a large population of Asian patients with CHF of differing etiology and severity (169 words).