Six Minute Walk Test Predicts Long-Term All-Cause Mortality and Heart Failure Rehospitalization in African-American Patients Hospitalized With Acute Decompensated Heart Failure

Background: The prognostic value of the 6-minute walk test (6MWT) has been described in patients with heart failure (HF); however, limited data are available in an African-American (AA) Population. We prospectively evaluated the usefulness of the 6MWT in predicting mortality and HF rehospitalization in AA patients with acute decompensated HF. Methods and Results: Two hundred AA patients (63.1% men, mean age 55.7 +/- 12.9 years) with acute decompensated HF were prospectively Studied. Patients were followed to assess 40-month all-cause mortality and 18-month HF rehospitalization. The median distance walked on the 6MWT was 213 m. 017 the 198 patients with available mortality data, 59 patients (29.8%) died. Of the 191 patients with available rehospitalization data. 114 (59.7%) were rehospitalized for worsening HE For patients who walked <= 200 in during the 6MWT. mortality was 41% compared with 19% in patients who walked >200 in (P =.001). For patients who walked <= 200 in during the 6MWT HF rehospitalization was 68% compared with 52% in those who walked >200 in (P =.027). Multivariate Cox regression analysis showed that 6MWT distance <= 200 m was the strongest predictor of mortality (adjusted hazard ratio [HR], 2.14 confidence interval 101, 1.20 to 3.81 P =.01) and HF rehospitalization (adjusted HR, 1.62; CL 1.10 to 2.39; P =.015). Conclusions: In AA patients hospitalized with acute decompensated HE 6MWT strongly and independently predicts long-term all-cause mortality and HF rehospitalization. (J Cardiac Fail 2009:15:130-135)