OBJECTIVES: In chronic thromboembolic pulmonary hypertension, objective data to assess the functional outcome after pulmonary endarterectomy are lacking. We studied the 6-minute walk distance in relation to the clinical and hemodynamic severity of disease, and assessed the effect of pulmonary endarterectomy on the 6-minute walk distance. METHODS: A total of 50 consecutive patients with chronic thromboembolic pulmonary hypertension were studied. Subsequently, pulmonary endarterectomy was performed in 42 patients, 35 of whom underwent a 6-minute walk distance 1 year after surgery. RESULTS: The mean +/- standard error of the mean 6-minute walk distance was 391 +/- 19 m. The 6-minute walk distance decreased in proportion to New York Heart Association functional class and correlated (all P < .0001) with mean pulmonary artery pressure (r = -0.62), cardiac output (r = 0.76), total pulmonary resistance (r = -0.75), mixed venous oxygen saturation (r = 0.77), and brain natriuretic peptide (r = -0.65). One year after pulmonary endarterectomy, the 6-minute walk distance increased from 417 +/- 19 m to 517 +/- 16 m (P < .0001). The change from baseline in 6-minute walk distance correlated with the changes after 1 year in New York Heart Association functional class (P < .01) and brain natriuretic peptide (r = 0.57, P < .002), and with the observed hemodynamic changes directly after pulmonary endarterectomy (change in mean pulmonary artery pressure: r = 0.52; change in cardiac output: r = 0.70; change in total pulmonary resistance r = 0.70; all P < .001). In patients with residual pulmonary hypertension after pulmonary endarterectomy, the 6-minute walk distance was significantly lower than in hemodynamically normalized patients. However, the absolute increase in the 6-minute walk distance was higher in patients with residual pulmonary hypertension (137 +/- 26 m and 82 +/- 20 m, respectively; P = .03). CONCLUSIONS: The 6-minute walk distance was demonstrated to reflect the clinical and hemodynamic severity of disease in patients with chronic thromboembolic pulmonary hypertension. One year after pulmonary endarterectomy, the 6-minute walk distance had increased significantly, and the change in the 6-minute walk distance correlated with the observed clinical and hemodynamic improvement.
OBJECTIVES: In chronic thromboembolic pulmonary hypertension, objective data to assess the functional outcome after pulmonary endarterectomy are lacking. We studied the 6-minute walk distance in relation to the clinical and hemodynamic severity of disease, and assessed the effect of pulmonary endarterectomy on the 6-minute walk distance. METHODS: A total of 50 consecutive patients with chronic thromboembolic pulmonary hypertension were studied. Subsequently, pulmonary endarterectomy was performed in 42 patients, 35 of whom underwent a 6-minute walk distance 1 year after surgery. RESULTS: The mean +/- standard error of the mean 6-minute walk distance was 391 +/- 19 m. The 6-minute walk distance decreased in proportion to New York Heart Association functional class and correlated (all P < .0001) with mean pulmonary artery pressure (r = -0.62), cardiac output (r = 0.76), total pulmonary resistance (r = -0.75), mixed venous oxygen saturation (r = 0.77), and brain natriuretic peptide (r = -0.65). One year after pulmonary endarterectomy, the 6-minute walk distance increased from 417 +/- 19 m to 517 +/- 16 m (P < .0001). The change from baseline in 6-minute walk distance correlated with the changes after 1 year in New York Heart Association functional class (P < .01) and brain natriuretic peptide (r = 0.57, P < .002), and with the observed hemodynamic changes directly after pulmonary endarterectomy (change in mean pulmonary artery pressure: r = 0.52; change in cardiac output: r = 0.70; change in total pulmonary resistance r = 0.70; all P < .001). In patients with residual pulmonary hypertension after pulmonary endarterectomy, the 6-minute walk distance was significantly lower than in hemodynamically normalized patients. However, the absolute increase in the 6-minute walk distance was higher in patients with residual pulmonary hypertension (137 +/- 26 m and 82 +/- 20 m, respectively; P = .03). CONCLUSIONS: The 6-minute walk distance was demonstrated to reflect the clinical and hemodynamic severity of disease in patients with chronic thromboembolic pulmonary hypertension. One year after pulmonary endarterectomy, the 6-minute walk distance had increased significantly, and the change in the 6-minute walk distance correlated with the observed clinical and hemodynamic improvement.
Authors: John E Morley; Angela Marie Abbatecola; Josep M Argiles; Vickie Baracos; Juergen Bauer; Shalender Bhasin; Tommy Cederholm; Andrew J Stewart Coats; Steven R Cummings; William J Evans; Kenneth Fearon; Luigi Ferrucci; Roger A Fielding; Jack M Guralnik; Tamara B Harris; Akio Inui; Kamyar Kalantar-Zadeh; Bridget-Anne Kirwan; Giovanni Mantovani; Maurizio Muscaritoli; Anne B Newman; Filippo Rossi-Fanelli; Giuseppe M C Rosano; Ronenn Roubenoff; Morris Schambelan; Gerald H Sokol; Thomas W Storer; Bruno Vellas; Stephan von Haehling; Shing-Shing Yeh; Stefan D Anker Journal: J Am Med Dir Assoc Date: 2011-07 Impact factor: 4.669
Authors: Sulaiman Surie; Herre J Reesink; Mart N van der Plas; Maxim Hardziyenka; Jaap J Kloek; Aeilko H Zwinderman; Paul Bresser Journal: Interact Cardiovasc Thorac Surg Date: 2012-09-20
Authors: Vandana Sachdev; Gregory J Kato; J Simon R Gibbs; Robyn J Barst; Roberto F Machado; Mehdi Nouraie; Kathryn L Hassell; Jane A Little; Dean E Schraufnagel; Lakshmanan Krishnamurti; Enrico M Novelli; Reda E Girgis; Claudia R Morris; Erika Berman Rosenzweig; David B Badesch; Sophie Lanzkron; Oswaldo L Castro; James G Taylor; Hwaida Hannoush; Jonathan C Goldsmith; Mark T Gladwin; Victor R Gordeuk Journal: Circulation Date: 2011-09-06 Impact factor: 29.690