TY - JOUR
T1 - Six-Minute Walk Test as a Predictor for Outcome in Children with Dilated Cardiomyopathy and Chronic Stable Heart Failure
AU - den Boer, Susanna L.
AU - Flipse, Daniël H.K.
AU - van der Meulen, Marijke H.
AU - Backx, Ad P.C.M.
AU - du Marchie Sarvaas, Gideon J.
AU - Ten Harkel, Arend D.J.
AU - van Iperen, Gabriëlle G.
AU - Rammeloo, Lukas A.J.
AU - Tanke, Ronald B.
AU - Helbing, Willem A.
AU - Takken, Tim
AU - Dalinghaus, Michiel
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Cardiopulmonary exercise testing is an important tool to predict prognosis in children and adults with heart failure. A much less sophisticated exercise test is the 6 min walk test, which has been shown an independent predictor for morbidity and mortality in adults with heart failure. Therefore, we hypothesized that the 6 min walk test could be predictive for outcome in children with dilated cardiomyopathy. We prospectively included 49 children with dilated cardiomyopathy ≥6 years who performed a 6 min walk test. Median age was 11.9 years (interquartile range [IQR] 7.4–15.1), median time after diagnosis was 3.6 years (IQR 0.6–7.4). The 6 min walk distance was transformed to a percentage of predicted, using age- and gender-specific norm values (6MWD%). For all patients, mean 6MWD% was 70 ± 21%. Median follow-up was 33 months (IQR 14–50). Ten patients reached the combined endpoint of death or heart transplantation. Using univariable Cox regression, a higher 6MWD% resulted in a lower risk of death or transplantation (hazard ratio 0.95 per percentage increase, p = 0.006). A receiver operating characteristic curve was generated to define the optimal threshold to identify patients at highest risk for an endpoint. Patients with a 6MWD% < 63% had a 2 year transplant-free survival of 73%, in contrast to a transplant-free survival of 92% in patients with a 6MWD% ≥ 63% (p = 0.003). In children with dilated cardiomyopathy, the 6 min walk test is a simple and feasible tool to identify children with a higher risk of death or heart transplantation.
AB - Cardiopulmonary exercise testing is an important tool to predict prognosis in children and adults with heart failure. A much less sophisticated exercise test is the 6 min walk test, which has been shown an independent predictor for morbidity and mortality in adults with heart failure. Therefore, we hypothesized that the 6 min walk test could be predictive for outcome in children with dilated cardiomyopathy. We prospectively included 49 children with dilated cardiomyopathy ≥6 years who performed a 6 min walk test. Median age was 11.9 years (interquartile range [IQR] 7.4–15.1), median time after diagnosis was 3.6 years (IQR 0.6–7.4). The 6 min walk distance was transformed to a percentage of predicted, using age- and gender-specific norm values (6MWD%). For all patients, mean 6MWD% was 70 ± 21%. Median follow-up was 33 months (IQR 14–50). Ten patients reached the combined endpoint of death or heart transplantation. Using univariable Cox regression, a higher 6MWD% resulted in a lower risk of death or transplantation (hazard ratio 0.95 per percentage increase, p = 0.006). A receiver operating characteristic curve was generated to define the optimal threshold to identify patients at highest risk for an endpoint. Patients with a 6MWD% < 63% had a 2 year transplant-free survival of 73%, in contrast to a transplant-free survival of 92% in patients with a 6MWD% ≥ 63% (p = 0.003). In children with dilated cardiomyopathy, the 6 min walk test is a simple and feasible tool to identify children with a higher risk of death or heart transplantation.
KW - 6-minute walk test
KW - Dilated cardiomyopathy
KW - Exercise test
KW - Pediatrics
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85000963089&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00246-016-1536-y
DO - https://doi.org/10.1007/s00246-016-1536-y
M3 - Article
C2 - 27909753
SN - 0172-0643
VL - 38
SP - 465
EP - 471
JO - Pediatric cardiology
JF - Pediatric cardiology
IS - 3
ER -