Prognostic Value of the 6-Min Walk Test After Open-Heart Valve Surgery: EXPERIENCE OF A CARDIOVASCULAR REHABILITATION PROGRAM

Giuseppe Vitale, Silvia Sarullo, Laura Vassallo, Antonino Di Franco, Giorgio Mandalà, Stefania Marazia, Giuseppe M Raffa, Francesco Giallauria, Filippo M Sarullo

Research output: Contribution to journalArticle

Abstract

PURPOSE: This single-center retrospective analysis aimed to evaluate the prognostic relevance of 6-min walk test (6MWT) in patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery.

METHODS: One hundred one patients able to perform a 6MWT within the first week of admission (time after surgery: 16 ± 8 d) were included (age 68 ± 11 y; 55% female; median left ventricular ejection fraction 55% [interquartile range: 50-60]; 51% after aortic valve surgery). Study endpoints were cardiovascular death and the combined outcome of cardiovascular death/cardiac hospitalization. Univariate and multivariate analyses were performed to analyze predictive value of the 6MWT.

RESULTS: After a median follow-up of 27 mo, cardiovascular mortality was 9.9% while combined endpoint occurrence was 33%. Patients experiencing study endpoints had lower left ventricular ejection fraction, higher N-terminal prohormone of brain natriuretic peptide serum levels, and longer in-hospital stay (all P < .05). The 6MWT distance was a significant predictor of cardiovascular death (hazard ratio [HR] = 0.89, 95% CI: 0.81-0.97, P = .007) and cardiac hospitalizations (HR = 0.95, 95% CI: 0.90-0.99, P = .02). Even after adjusting for the relevant confounding variables of cardiovascular death and cardiac hospitalization, the adjusted HR = 0.88, 95% CI: 0.75-0.98, P = .028 and adjusted HR = 0.95, 95% CI: 0.90-0.99, P = .05, respectively.

CONCLUSIONS: In patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery, 6MWT proved to be an independent prognostic tool, potentially allowing identification of high-risk patients for whom a more intensive and tailored in-hospital cardiovascular rehabilitation program should be designed and implemented in order to avoid unfavorable cardiovascular events.

Original languageEnglish
Pages (from-to)304-308
Number of pages5
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume38
Issue number5
DOIs
Publication statusPublished - Sep 2018

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Heart Valves
Thoracic Surgery
Hospitalization
Stroke Volume
Confounding Factors (Epidemiology)
Brain Natriuretic Peptide
Aortic Valve
Length of Stay
Multivariate Analysis
Cardiac Rehabilitation
Walk Test
Mortality
Serum

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Prognostic Value of the 6-Min Walk Test After Open-Heart Valve Surgery : EXPERIENCE OF A CARDIOVASCULAR REHABILITATION PROGRAM. / Vitale, Giuseppe; Sarullo, Silvia; Vassallo, Laura; Di Franco, Antonino; Mandalà, Giorgio; Marazia, Stefania; Raffa, Giuseppe M; Giallauria, Francesco; Sarullo, Filippo M.

In: Journal of Cardiopulmonary Rehabilitation and Prevention, Vol. 38, No. 5, 09.2018, p. 304-308.

Research output: Contribution to journalArticle

Vitale, Giuseppe ; Sarullo, Silvia ; Vassallo, Laura ; Di Franco, Antonino ; Mandalà, Giorgio ; Marazia, Stefania ; Raffa, Giuseppe M ; Giallauria, Francesco ; Sarullo, Filippo M. / Prognostic Value of the 6-Min Walk Test After Open-Heart Valve Surgery : EXPERIENCE OF A CARDIOVASCULAR REHABILITATION PROGRAM. In: Journal of Cardiopulmonary Rehabilitation and Prevention. 2018 ; Vol. 38, No. 5. pp. 304-308.
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abstract = "PURPOSE: This single-center retrospective analysis aimed to evaluate the prognostic relevance of 6-min walk test (6MWT) in patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery.METHODS: One hundred one patients able to perform a 6MWT within the first week of admission (time after surgery: 16 ± 8 d) were included (age 68 ± 11 y; 55{\%} female; median left ventricular ejection fraction 55{\%} [interquartile range: 50-60]; 51{\%} after aortic valve surgery). Study endpoints were cardiovascular death and the combined outcome of cardiovascular death/cardiac hospitalization. Univariate and multivariate analyses were performed to analyze predictive value of the 6MWT.RESULTS: After a median follow-up of 27 mo, cardiovascular mortality was 9.9{\%} while combined endpoint occurrence was 33{\%}. Patients experiencing study endpoints had lower left ventricular ejection fraction, higher N-terminal prohormone of brain natriuretic peptide serum levels, and longer in-hospital stay (all P < .05). The 6MWT distance was a significant predictor of cardiovascular death (hazard ratio [HR] = 0.89, 95{\%} CI: 0.81-0.97, P = .007) and cardiac hospitalizations (HR = 0.95, 95{\%} CI: 0.90-0.99, P = .02). Even after adjusting for the relevant confounding variables of cardiovascular death and cardiac hospitalization, the adjusted HR = 0.88, 95{\%} CI: 0.75-0.98, P = .028 and adjusted HR = 0.95, 95{\%} CI: 0.90-0.99, P = .05, respectively.CONCLUSIONS: In patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery, 6MWT proved to be an independent prognostic tool, potentially allowing identification of high-risk patients for whom a more intensive and tailored in-hospital cardiovascular rehabilitation program should be designed and implemented in order to avoid unfavorable cardiovascular events.",
author = "Giuseppe Vitale and Silvia Sarullo and Laura Vassallo and {Di Franco}, Antonino and Giorgio Mandal{\`a} and Stefania Marazia and Raffa, {Giuseppe M} and Francesco Giallauria and Sarullo, {Filippo M}",
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TY - JOUR

T1 - Prognostic Value of the 6-Min Walk Test After Open-Heart Valve Surgery

T2 - EXPERIENCE OF A CARDIOVASCULAR REHABILITATION PROGRAM

AU - Vitale, Giuseppe

AU - Sarullo, Silvia

AU - Vassallo, Laura

AU - Di Franco, Antonino

AU - Mandalà, Giorgio

AU - Marazia, Stefania

AU - Raffa, Giuseppe M

AU - Giallauria, Francesco

AU - Sarullo, Filippo M

PY - 2018/9

Y1 - 2018/9

N2 - PURPOSE: This single-center retrospective analysis aimed to evaluate the prognostic relevance of 6-min walk test (6MWT) in patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery.METHODS: One hundred one patients able to perform a 6MWT within the first week of admission (time after surgery: 16 ± 8 d) were included (age 68 ± 11 y; 55% female; median left ventricular ejection fraction 55% [interquartile range: 50-60]; 51% after aortic valve surgery). Study endpoints were cardiovascular death and the combined outcome of cardiovascular death/cardiac hospitalization. Univariate and multivariate analyses were performed to analyze predictive value of the 6MWT.RESULTS: After a median follow-up of 27 mo, cardiovascular mortality was 9.9% while combined endpoint occurrence was 33%. Patients experiencing study endpoints had lower left ventricular ejection fraction, higher N-terminal prohormone of brain natriuretic peptide serum levels, and longer in-hospital stay (all P < .05). The 6MWT distance was a significant predictor of cardiovascular death (hazard ratio [HR] = 0.89, 95% CI: 0.81-0.97, P = .007) and cardiac hospitalizations (HR = 0.95, 95% CI: 0.90-0.99, P = .02). Even after adjusting for the relevant confounding variables of cardiovascular death and cardiac hospitalization, the adjusted HR = 0.88, 95% CI: 0.75-0.98, P = .028 and adjusted HR = 0.95, 95% CI: 0.90-0.99, P = .05, respectively.CONCLUSIONS: In patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery, 6MWT proved to be an independent prognostic tool, potentially allowing identification of high-risk patients for whom a more intensive and tailored in-hospital cardiovascular rehabilitation program should be designed and implemented in order to avoid unfavorable cardiovascular events.

AB - PURPOSE: This single-center retrospective analysis aimed to evaluate the prognostic relevance of 6-min walk test (6MWT) in patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery.METHODS: One hundred one patients able to perform a 6MWT within the first week of admission (time after surgery: 16 ± 8 d) were included (age 68 ± 11 y; 55% female; median left ventricular ejection fraction 55% [interquartile range: 50-60]; 51% after aortic valve surgery). Study endpoints were cardiovascular death and the combined outcome of cardiovascular death/cardiac hospitalization. Univariate and multivariate analyses were performed to analyze predictive value of the 6MWT.RESULTS: After a median follow-up of 27 mo, cardiovascular mortality was 9.9% while combined endpoint occurrence was 33%. Patients experiencing study endpoints had lower left ventricular ejection fraction, higher N-terminal prohormone of brain natriuretic peptide serum levels, and longer in-hospital stay (all P < .05). The 6MWT distance was a significant predictor of cardiovascular death (hazard ratio [HR] = 0.89, 95% CI: 0.81-0.97, P = .007) and cardiac hospitalizations (HR = 0.95, 95% CI: 0.90-0.99, P = .02). Even after adjusting for the relevant confounding variables of cardiovascular death and cardiac hospitalization, the adjusted HR = 0.88, 95% CI: 0.75-0.98, P = .028 and adjusted HR = 0.95, 95% CI: 0.90-0.99, P = .05, respectively.CONCLUSIONS: In patients admitted to an in-hospital cardiovascular rehabilitation program after open-heart valve surgery, 6MWT proved to be an independent prognostic tool, potentially allowing identification of high-risk patients for whom a more intensive and tailored in-hospital cardiovascular rehabilitation program should be designed and implemented in order to avoid unfavorable cardiovascular events.

U2 - 10.1097/HCR.0000000000000340

DO - 10.1097/HCR.0000000000000340

M3 - Article

C2 - 29952806

VL - 38

SP - 304

EP - 308

JO - Journal of Cardiopulmonary Rehabilitation and Prevention

JF - Journal of Cardiopulmonary Rehabilitation and Prevention

SN - 1932-7501

IS - 5

ER -