ABC | Volume 114, Nº3, March 2020

Original Article Farah et al. Effort during 6-minute walk test Arq Bras Cardiol. 2020; 114(3):486-492 1. Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. 2. Makdisse M, Pereira Ada C, Brasil Dde P, Borges JL, Machado-Coelho GL, Krieger JE, et al. Prevalence and risk factors associatedwith peripheral arterial disease in the Hearts of Brazil Project. Arquivos brasileiros de cardiologia. 2008;91(6):370-82. 3. McDermott MM, Greenland P, Ferrucci L, Criqui MH, Liu K, Sharma L, et al. Lower extremity performance is associated with daily life physical activity in individuals with andwithout peripheral arterial disease. J AmGeriatr Soc. 2002;50(2):247-55. 4. CamaraLC,Ritti-DiasRM,MenesesAL,D’AndreaGreveJM,FilhoWJ,Santarem JM, et al. Isokinetic strength and endurance in proximal and distal muscles in patients with peripheral artery disease. Ann Vasc Surg. 2012;26(8):1114-9. 5. Meneses AL, Farah BQ, Ritti-Dias RM. Muscle function in individuals with peripheral arterial obstructive disease: A systematic review. Motricidade. 2012;8(1):86-96. 6. Farah BQ, Ritti-Dias RM, Cucato GG, Chehuen Mda R, Barbosa JP, Zeratti AE, et al. Effects of clustered comorbid conditions on walking capacity in patients with peripheral artery disease. Ann Vasc Surg. 2014;28(2):279-83. 7. Womack CJ, Sieminski DJ, Katzel LI, Yataco A, Gardner AW. Oxygen uptake during constant-intensity exercise in patients with peripheral arterial occlusive disease. Vasc Med. 1997;2(3):174-8. 8. Wasserman K, Hansen J, Sue D, Whipp B, Casaburi R. Principle of Exercise Testing and Interpretation. In: 2nd, ed. Washington, DC: Lea & Febinger; 1994. 241 p. 9. Farah BQ, Ritti-Dias RM, Cucato GG, Meneses AL, Gardner AW. Clinical predictorsofventilatorythresholdachievement inpatientswithclaudication. Med Sci Sports Exerc. 2015;47(3):493-7. 10. Rocha CM, Cucato GG, Barbosa JAS, Costa RL, Ritti-Dias RM, Wolosker N, et al. Ventilatory threshold is related to walking tolerance in patients with intermittent claudication. VASA. 2012;41(4):275-81. 11. Cucato GG, Chehuen Mda R, Costa LA, Ritti-Dias RM, Wolosker N, Saxton JM, et al. Exercise prescription using the heart of claudication pain onset in patients with intermittent claudication. Clinics (Sao Paulo). 2013;68(7):974-8. 12. Ritti-Dias RM, de Moraes Forjaz CL, Cucato GG, Costa LA, Wolosker N, Marucci MFN. Pain threshold is achieved at intensity above anaerobic threshold in patients with intermittent claudication. J Cardiopulm Rehabil Prev. 2009;29(6):396-401. 13. Montgomery PS, Gardner AW. The clinical utility of a six-minute walk test in peripheral arterial occlusive disease patients. J Am Geriatr Soc. 1998;46(6):706-11. 14. Gardner AW, Parker DE, Montgomery PS, Blevins SM. Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: a randomized controlled trial. J AmHeart Assoc. 2014;3(5):e001107. 15. Gardner AW, Parker DE, Montgomery PS, Scott KJ, Blevins SM. Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: a randomized controlled trial. Circulation. 2011;123(5):491-8. References restricted to these patients. In addition, to accurately detect the VT in the 6-minute walk test, we only included patients that did not stop while performing it. These findings are also limited by the relatively small sample size, particularly when it comes to patients who did not achieve the VT. Conclusion More than half of patients with symptomatic PAD achieved VT during the 6-minute walk test. Men and patients with lower cardiorespiratory fitness are more likely to achieve VT during the 6-minute walk test. Acknowledgments This study was funded by the National Institute on Aging (R01-AG-24296), Oklahoma Center for Advancement of Science and Technology (HR09-035), and OUHSC General Clinical Research Center (M01-RR-14467) from National Center for Research Resources. Author contributions Conception and design of the research: Farah BQ, Dias RR, Cucato G, Gardner A; Acquisition of data: Montgorery P, Gardner A; Analysis and interpretation of the data: Farah BQ, Dias RR, Gardner A; Statistical analysis: Farah BQ; Obtaining financing: Gardner A; Writing of the manuscript: Farah BQ, Dias RR, Cucato G; Critical revision of the manuscript for intellectual content: Montgorery P, Gardner A. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by National Institute on Aging (R01- AG-24296), Oklahoma Center for Advancement of Science and Technology (HR09-035), and OUHSC General Clinical Research Center (M01-RR-14467) of National Center for Research Resourcer. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the University of Oklahoma Health Sciences Center under the protocol number 2337. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 490