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Comparison of the 6-minute walk test with established parameters for assessment of cardiopulmonary capacity in adults with complex congenital cardiac disease

Published online by Cambridge University Press:  13 July 2005

Andreas Niedeggen ,
Erik Skobel ,
Philipp Haager ,
Wolfgang Lepper ,
Eberhard Mühler  and
Andreas Franke
Andreas Niedeggen
Affiliation:
Department of Cardiology, University Hospital, Aachen, Germany
Erik Skobel
Affiliation:
Department of Cardiology, University Hospital, Aachen, Germany
Philipp Haager
Affiliation:
Department of Cardiology, University Hospital, Aachen, Germany
Wolfgang Lepper
Affiliation:
Department of Cardiology, University Hospital, Aachen, Germany
Eberhard Mühler
Affiliation:
Department of Paediatric Cardiology, University Hospital, Aachen, Germany
Andreas Franke
Affiliation:
Department of Cardiology, University Hospital, Aachen, Germany
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Abstract

Background: Objective assessment of the cardiopulmonary capacity in patients with complex congenital cardiac disease often remains difficult in clinical practice. The cardiopulmonary exercise test and determination of the levels of brain natriuretic peptide in the plasma are established tests, but expensive. The 6-minute walk test is also validated, but has not often been used in patients with heart failure due to congenital heart disease, nor compared with other tests. We sought to compare its value with the results of cardiopulmonary exercise testing and measuring the levels of brain natriuretic peptide in the plasma. Methods: We carried out a standardized 6-minute walk test in 31 patients with complex congenital cardiac disease on the same day that they underwent cardiopulmonary exercise testing and determination of levels of brain natriuretic peptide in the plasma. Of the patients, 7 had functionally univentricular hearts, 9 had transposition, 9 had tetralogy of Fallot, 3 had common arterial trunk, and 3 had pulmonary atresia with intact interventricular septum. Uptakes of oxygen at peak exercise, and at the anaerobic threshold, were determined using cardiopulmonary exercise testing, and classified as suggested by Weber. The 6-minute walk test was performed according to a standard protocol. Results: There was a significant correlation between brain natriuretic peptide, oxygen uptakes at peak exercise and 6-minute walk. The correlation between the 6-minute walk test and oxygen uptakes at the anaerobic threshold, however, was not significant. Conclusions: The 6-minute walk test can be performed easily, is inexpensive, widely available, and correlates well with measurements of brain natriuretic peptide and cardiopulmonary exercise testing, even in patients with corrected or palliated congenital cardiac malformations. A cut-off value of 450 metres in the 6-minute walk test allows a semi-quantitative classification in analogy to the classification suggested by Weber for cardiopulmonary exercise testing, and to a level of brain natriuretic peptide in the plasma of less or more than 100 picograms per millilitre.

Keywords

Heart failurebrain natriuretic peptideexercise capacity
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 4 , August 2005 , pp. 385 - 390
Copyright
© 2005 Cambridge University Press

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