Value of the 6 minute walk test in predicting multi vessel coronary arterial disease

Ruvan Ekanayaka, Yasindu Waniganayake

Institute of Cardiology, National Hospital of Sri Lanka, Colombo, Sri Lanka.

DOI: 10.4236/ojim.2013.32010                

Abstract

The 6 minute walk test (6MWT) is well established in the clinical assessment of heart failure, pulmonary hypertension and COPD. Its value as a submaximal stress test in the risk stratification of chronic stable ischaemic syndromes is as yet not validated. 95 patients undergoing coronary angiography for assessment of chronic stable angina performed the 6MWT according to a modified protocol. The gamma correlation test indicated a moderately significant relationship between ECG changes plus symptoms at the end of the 6MWT and multi vessel coronary arterial disease. The T wave changes showed no significant correlation. Hence the 6MWT is a useful tool in the risk stratification of stable ischaemic syndromes which can be safely performed in a general ward prior to hospital discharge. It would be a useful preliminary test before planning a programme of cardiac rehabilitation.

Keywords

Coronary Angiogram; 6 Minute Walk Test; Multi Vessel Coronary Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Kappagoda, C. (1984) Rehabilitation after myocardial infarction. Medical Examination Publishing Co., Inc., New York, 72.
[2]	Goldschlager. N., Selzer, A. and Cohn, K. (1976) Treadmill stress tests as indicators of presence and severity of coronary artery disease. Annals of Internal Medicine, 85, 277. doi:10.7326/0003-4819-85-3-277
[3]	ESC (2007) Compendium of ESC guidelines 2007. Lippincott Williams and Wilkins, 80.
[4]	Fuster, V., Ed. (2009) The AHA guidelines and scientific statements handbook. Wiley-Blackwell, Dallas, 81.
[5]	Robert, O.B., Douglas, L.M., Douglas, P.Z., Peter, L. and Braunwald, E., Eds. (2012) Braunwald’s heart disease. 9th Edition, Elsevier Saunders, Philadelphia, 171, 1159.
[6]	Olsson, L.G., Swedberg, K., Clark, A.L., Witte, K.K. and Cleland, J.G. (2005) Six minute corridor walk test as an outcome measure for the assessment of treatment in randomized, blinded intervention trials of chronic heart failure: A systemic review. European Heart Journal, 26, 778-793. doi:10.1093/eurheartj/ehi162
[7]	Refsgaard, J. (2005) “This is a walking test, not a talking test”: The six minute walking test in congestive heart failure. European Heart Journal, 26, 749-750. doi:10.1093/eurheartj/ehi207
[8]	Reybrouck, T. (2003) Clinical usefulness and limitations of the 6-minute walk test in patients with cardiovascular or pulmonary disease. Chest, 123, 325-327. doi:10.1378/chest.123.2.325
[9]	Beatty, A.L. (2012) Six-minute walk test as a prognostic tool in stable coronary heart disease. Archives of Internal Medicine, 172, 1096-1102. doi:10.1001/archinternmed.2012.2198
[10]	Guimaraes, G.V., Carvalho, V.O. and Bocchi, E.A. (2008) Reproducibility of the self-controlled six-minute walking test in heart failure patients. Clinics, 63, 201-206. doi:10.1590/S1807-59322008000200008
[11]	Griffin, B.P., Topol, E.J., Nair, D. and Ashley, K., Eds. (2009) Manual of cardiovascular medicine. 3rd Edition, Lippincott Williams and Wilkins, Philadelphia, 602.
[12]	Mark, D.B., Hlatky, M.A., Harrell Jr., F.E., et al. (1987) Exercise treadmill score for predicting prognosis in coronary artery disease. Annals of Internal Medicine, 106, 793-800. doi:10.7326/0003-4819-106-6-793
[13]	Sharma, K., Kohli, P. and Gulati, M. (2012) An update on exercise stress testing. Current Problems in Cardiology, 37, 194. doi:10.1016/j.cpcardiol.2011.11.004
[14]	Gauri, A.J., Raxwal, V.K., Roux, L., et al. (2001) Effects of chronotropic incompetence and beta blocker use on the exercise treadmill test in men. American Heart Journal, 142, 136-141. doi:10.1067/mhj.2001.115788
[15]	ATS Statement (2002) Guidelines for the six-minutes walk test. American Journal of Respiratory and Critical Care Medicine, 166, 111-117. doi:10.1164/ajrccm.166.1.at1102
[16]	Strokengine.ca. Canadain stroke network. http://strokengine.ca/assess/module_6mwt_indepth-en.html
[17]	Wu, G., Sanderson, B. and Bittner, V. (2003) The 6-minute walk test: How important is the learning effect. American Heart Journal, 146, 129-133. doi:10.1016/S0002-8703(03)00119-4
[18]	De Almeida, F.G., Victor, E.G. and Rizzo, J.A. (2009) Hallway versus treadmill 6-minute-walk tests in patients with chronic obstructive pulmonary disease. Respir Care, 54, 1712-1716.
[19]	Miyamoto, S., Nagaya, N., Satoh, T., Kyotani, S., Sakamaki, F., Fujita, M., et al. (2000) Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension, comparison with cardiopulmonary testing. American Journal of Respiratory and Critical Care Medicine, 161, 487-492. doi:10.1164/ajrccm.161.2.9906015
[20]	Guazzi, M., Dickstein, K., Vicenzi, M. and Arena, R. (2009) Six-minute walk test and cardiopulmonary exercise testing in patients with chronic heart failure, a comparative analysis on clinical and prognostic insights. Circular Heart Failure, 2, 549-555.