Evidence map›Paper›PMID 23177293›Full record

Trial reportJournal of the American College of Cardiology2012

6-min walk test provides prognostic utility comparable to cardiopulmonary exercise testing in ambulatory outpatients with systolic heart failure.

Daniel E Forman, Jerome L Fleg, Dalane W Kitzman, Clinton A Brawner, Ann M Swank, Robert S McKelvie, Robert M Clare, Stephen J Ellis, Mark E Dunlap, Vera Bittner

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 5 pooled it
41.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 5 syntheses or guidelines pooled it, 213 citations in OpenAlex.

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  18. Incremental and independent value of cardiopulmonary exercise test measures and the Seattle Heart Failure Model for prediction of risk in patients with heart failure.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2015
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 9 institutions in 3 countries.

Daniel E FormanDivision of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. deforman@partners.org
Jerome L Fleg
Dalane W Kitzman
Clinton A Brawner
Ann M Swank
Robert S McKelvie
Robert M Clare
Stephen J Ellis
Mark E Dunlap
Vera Bittner
Durham University · GBBrigham and Women's Hospital · USHamilton Health Sciences · CAHenry Ford Hospital · USMetroHealth Medical Center · USNational Heart Lung and Blood Institute · USUniversity of Alabama at Birmingham · USUniversity of Louisville · USWake Forest University · US

Funding

ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL068973 · NHLBI · BOSTON MEDICAL CENTER · PI COLUCCI, WILSON S. · 2002 to 2007
$1.0M
NHLBI NIH HHS U01 HL068973
6 · The paper itself

Abstract

objectivesThe goal of this study was to compare the prognostic efficacy of the 6-min walk (6MW) and cardiopulmonary exercise (CPX) tests in stable outpatients with chronic heart failure (HF).

backgroundCPX and 6MW tests are commonly applied as prognostic gauges for systolic HF patients, but few direct comparisons have been conducted.

methodsStable New York Heart Association (NYHA) functional class II and III systolic HF patients (ejection fraction ≤ 35%) from the HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) trial were studied. 6MW distance (6MWD) and CPX indices (peak oxygen consumption [VO(2)] and ventilatory equivalents for exhaled carbon dioxide [VE/VCO(2)] slope) were compared as predictors of all-cause mortality/hospitalization and all-cause mortality over 2.5 years of mean follow-up.

resultsA total of 2,054 HF-ACTION participants underwent both CPX and 6MW tests at baseline (median age 59 years; 71% male; 64% NYHA functional class II and 36% NYHA functional class III/IV). In unadjusted models and in models that included key clinical and demographic covariates, C-indices of 6MWD were 0.58 and 0.65 (unadjusted) and 0.62 and 0.72 (adjusted) in predicting all-cause mortality/hospitalization and all-cause mortality, respectively. C-indices for peak VO(2) were 0.61 and 0.68 (unadjusted) and 0.63 and 0.73 (adjusted). C-indices for VE/VCO(2) slope were 0.56 and 0.65 (unadjusted) and 0.61 and 0.71 (adjusted); combining peak VO(2) and VE/VCO(2) slope did not improve the C-indices. Overlapping 95% confidence intervals and modest integrated discrimination improvement values confirmed similar prognostic discrimination by 6MWD and CPX indices within adjusted models.

conclusionsIn systolic HF outpatients, 6MWD and CPX indices demonstrated similar utility as univariate predictors for all-cause hospitalization/mortality and all-cause mortality. However, 6MWD or CPX indices added only modest prognostic discrimination to models that included important demographic and clinical covariates.

Indexed as

OutpatientsAdultAgedExerciseExercise TestExercise TherapyFemaleFollow-Up StudiesHeart Failure, SystolicHumansMaleMiddle AgedOxygen ConsumptionPrognosisSurvival RateUnited States

Identifiers

PMID23177293
PMCPMC3766897
OpenAlexW1999968533

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.