IJCS | Volume 32, Nº2, March/April 2019

DOI: 10.5935/2359-4802.20180088 134 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(2)134-142 Mailing Address: Elizabeth Rodrigues de Morais Rua C252, 468, quadra: 567, lote: 21, Setor Nova Suiça, Postal Code: 74.180-260, Goiânia- Goiás, Brazil. E-mail: elizabeth.r.morais@hotmail.com Determinants of the Distance Covered During a Six-Minute Walk Test in Patients with Chronic Heart Failure Elizabeth Rodrigues de Morai s a nd Salvador Ras si Universidade Federal de Goiás (UFG), GO - Brazil Manuscript received March 08, 2018, revised manuscript August 01, 2018, accepted August 07, 2018. Abstract Background: The evaluation of the functional capacity of patients with chronic heart failure (HF) by means of the distance covered in the six-minute walk test (6MWT) has assumed great importance, since the 6MWD is a predictor of mortality and hospitalization in this population, however the determinants of better distance traveled in patients with HF are little explored, especially in the Brazilian population. Objective: To evaluate the determinants of 6MWD in patients with chronic HF. Methods: A cross-sectional study was performed with 81 HF patients in outpatient treatment. 6MWD was used as the outcome variable and sociodemographic, clinical, physical-functional and emotional data were submitted to multiple regression analysis using the stepwise method with a significance level of 5%. Results: Mean age of participants was 56.71 years; the 6MWD showed a bivariate correlation with age (r = -0.27, p = 0.01), maximal inspiratory pressure (r = 0.42, p < 0.01), maximal expiratory pressure (r = 0.36, p < 0.01), handgrip strength (r = 0.38, p < 0.01), Borg scale (-0.22, p = 0.04), Charlson index (r = -0.25, p = 0.02) and modified Medical Research Council (mMRC) dyspnea scale (r = -0.42, p < 0.01). In the multivariate analysis, the variables gender (p = 0.001), age (0.004), forced vital capacity (FVC) (p = 0.016) and mMRC (p = 0.001) simultaneously explained 37% of variance in the 6MWD. Conclusion: Higher levels of dyspnea on daily life activities, female sex, older age and lower forced vital capacity are determinants of a shorter 6MWD in patients with chronic HF. (Int J Cardiovasc Sci. 2019;32(2)134-142) Keywords: Heart Failure/physiopathology; Heart Failure/diagnosis; Walk Test/methods; Health Status Indicators; Reference Standards. Introduction Maximal effort test is the gold standardmethod for the assessment of functional capacity. 1 The six-minute walk test (6MWT), however, has become equally important to this end, and has been used as a simple, reproducible and feasible alternative. Since the 80’s, the 6MWT has been widely used in clinical practice to evaluate functional capacity in heart failure (HF) patients, especially since the publication of the Studies of Left Ventricular Dysfunction (SOLVD), 2 showing that the distance walked was an independent predictor of mortality in patients with New York Heart Association (NYHA) classes II and III. Functional capacity must be a priority in the management of elderly patients with cardiovascular disease. The assessment tools should have clinical applicability, be practical and efficient, since the maximal effort test is not always available. Besides, the prevalence of orthopedic and neurologic diseases has increasedwith population aging, which can make it difficult to perform exercise tests that require maximal effort. 3 In light of this, 6MWT will become more and more present in the clinical practice, which makes it important to establish which variables may have affect its results, as well as intervention and prevention strategies for HF