OBJECTIVES: This study sought to define the prognostic significance and clinical determinants of the 6-min walk distance (6-MWD) in affected patients. BACKGROUND: Symptoms of exertional fatigue and dyspnea, as well as a reduced exercise tolerance, are cardinal features of pulmonary hypertension associated with heart failure and preserved ejection fraction (PH-HFpEF). Mechanisms limiting exercise capacity in this specific entity remain incompletely understood. METHODS: Consecutive patients with PH-HFpEF, as confirmed by right heart catheter, were enrolled in our prospective registry. Hospitalization for HF and/or death for cardiac reasons were defined as primary outcome. Multiple regression models were constructed to establish determinants of the 6-MWD. For quantification of left ventricular (LV) extracellular matrix (ECM), myocardial biopsies were taken from 18 patients. RESULTS: Between December 2010 and July 2013, 142 PH-HFpEF patients were included in the study. After a mean follow-up of 14.0 ± 10.0 months, 43 patients (30.3%) reached the combined endpoint. The 6-MWD was found to be an independent predictor of outcome and was influenced by a variety of clinical, echocardiographic, hemodynamic, laboratory, and pulmonary parameters. There was a significant inverse correlation between the 6-MWD and the extent of ECM in the LV myocardium. CONCLUSIONS: Impaired exercise capacity in PH-HFpEF patients is explained by cardiac and noncardiac factors. The 6-MWD predicts outcome and may be a useful endpoint in clinical trials.
OBJECTIVES: This study sought to define the prognostic significance and clinical determinants of the 6-min walk distance (6-MWD) in affected patients. BACKGROUND: Symptoms of exertional fatigue and dyspnea, as well as a reduced exercise tolerance, are cardinal features of pulmonary hypertension associated with heart failure and preserved ejection fraction (PH-HFpEF). Mechanisms limiting exercise capacity in this specific entity remain incompletely understood. METHODS: Consecutive patients with PH-HFpEF, as confirmed by right heart catheter, were enrolled in our prospective registry. Hospitalization for HF and/or death for cardiac reasons were defined as primary outcome. Multiple regression models were constructed to establish determinants of the 6-MWD. For quantification of left ventricular (LV) extracellular matrix (ECM), myocardial biopsies were taken from 18 patients. RESULTS: Between December 2010 and July 2013, 142 PH-HFpEF patients were included in the study. After a mean follow-up of 14.0 ± 10.0 months, 43 patients (30.3%) reached the combined endpoint. The 6-MWD was found to be an independent predictor of outcome and was influenced by a variety of clinical, echocardiographic, hemodynamic, laboratory, and pulmonary parameters. There was a significant inverse correlation between the 6-MWD and the extent of ECM in the LV myocardium. CONCLUSIONS: Impaired exercise capacity in PH-HFpEF patients is explained by cardiac and noncardiac factors. The 6-MWD predicts outcome and may be a useful endpoint in clinical trials.
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Authors: Ambarish Pandey; Dalane W Kitzman; Peter Brubaker; Mark J Haykowsky; Timothy Morgan; J Thomas Becton; Jarett D Berry Journal: J Am Geriatr Soc Date: 2017-03-24 Impact factor: 5.562
Authors: Ravi B Patel; Benjamin H Freed; Lauren Beussink-Nelson; Norrina B Allen; Suma H Konety; Wendy S Post; Joseph Yeboah; Dalane W Kitzman; Alain G Bertoni; Sanjiv J Shah Journal: J Am Coll Cardiol Date: 2021-05-13 Impact factor: 27.203
Authors: Elżbieta Domka-Jopek; Andrzej Jopek; Agnieszka Bejer; Ewa Lenart-Domka; Grzegorz Walawski Journal: Biomed Res Int Date: 2018-07-04 Impact factor: 3.411
Authors: Franz Duca; Caroline Zotter-Tufaro; Andreas A Kammerlander; Stefan Aschauer; Christina Binder; Julia Mascherbauer; Diana Bonderman Journal: Sci Rep Date: 2018-01-18 Impact factor: 4.379