Prognostic importance of the reason for six-minute walk test interruption in hospitalized older patients with heart failure.

Abstract

Aim: The six-minute walk test (6MWT) allows patients to slow down, stop and rest as needed. However, the prognostic significance of 6MWT interruption remains unclear. Therefore, this study investigated the prognostic implications of 6MWT interruption in patients with heart failure (HF).

Methods: Patients hospitalized with HF who underwent 6MWT before discharge were included. They were stratified into three groups: those who completed the 6MWT, those who interrupted the test because of dyspnea or leg fatigue and those who interrupted the test for other reasons. The primary outcome was 2-year mortality.

Results: In total, 1180 patients were analyzed; 749 completed the 6MWT, 341 interrupted it because of dyspnea or leg fatigue and 90 interrupted it for other reasons. During the 2-year follow-up period, 238 patients (20.2%) died. In the Kaplan-Meier analysis, 6MWT interruption due to dyspnea/leg fatigue was associated with a significantly higher 2-year mortality rate, which remained significant even after adjustment for conventional risk factors, including the 6MWD and the Borg score measured after the 6MWT. However, 6MWT interruption for other reasons was not significantly associated with mortality.

Conclusion: In hospitalized patients with HF, 6MWT interruption due to dyspnea or leg fatigue was independently associated with higher 2-year mortality, regardless of the 6MWD. These findings suggest that 6MWT interruption might be a valuable prognostic marker for HF management. Geriatr Gerontol Int 2025; ••: ••-••.