Medicine Poster Session
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Results
Clinical, hemodynamic and echocardiographic characteristics of the patients are given in Table 1. Twenty eight patients were in NYHA functional class I, 44 patients in class II and 44 patients in class III. The study patients were taking a variety of medications, including angiotensin-converting enzyme inhibitors, diuretics, digitalis, beta-blockers, nitrates and aspirin.
| Table 1. Characteristics of the study patients | Age (years) | 55+/-11 |
| Weight (kg) | 76+/-13 |
| Heart Rate (beats/min) | 82+/-12 |
| Systolic Arterial Pressure (mm Hg) | 130+/-21 |
| Diastolic Arterial Pressure (mm Hg) | 82+/-12 |
| NYHA class | 2.14+/-0.78 |
| Left Atrial Size (mm) | 45+/-7 |
| LV Mass Index (g/m2) | 140+/-43 |
| LV End-Systolic Volume Index (ml/m2) | 77+/-36 |
| LV End-Diastolic Volume Index (ml/m2) | 120+/-38 |
| LV Ejection Fraction (%) | 34+/-6 |
| Isovolumic Relaxation Time (ms) | 79+/-25 |
| Peak Velocity of Early Filling (m/s) | 0.54+/-0.13 |
| Peak Velocity of Atrial Filling (m/s) | 0.42+/-0.14 |
| PE/PA ratio | 1.47+/-0.64 |
| Deceleration Time of Early Filling (ms) | 140+/-29 |
Only one patient was unable to perform the 6 MW test, 9 patients completed the walk with breaks in continuity. The mean distance walked was 277+/-114 m. Hemodynamic, echocardiographic and Doppler-derived variables correlated with 6 MW test distance on univariate analysis are listed in Table 2. A significant inverse correlation also existed between NYHA functional class and 6 MW test distance (r=-0.435, p=0.000).
| Table 2. Correlations between six-minute walk test distance and hemodynamic, echocardiographic, and Doppler-derived parameters | ||||
| Parameter | r | Regression equation | p Value | SEE |
| HR | -0.362 | y=552.56-3.35 x | 0.000 | 107.14 |
| SAP | 0.255 | y=100.37+1.36 x | 0.006 | 111.15 |
| DAP | 0.219 | y=108.13+2.06 x | 0.019 | 112.15 |
| LA size | -0.378 | y=540.96-5.82 x | 0.000 | 106.43 |
| LVM index | -0.436 | y=438.26-1.15 x | 0.000 | 103.46 |
| LVESV index | -0,549 | y=411.52-1.74 x | 0.000 | 96.04 |
| LVEDV index | -0.512 | y=464.11-1.56 x | 0.000 | 98.76 |
| LVEF | 0.509 | y=-35.82+9.25 x | 0.000 | 98.93 |
| IVRT | 0.580 | y=70.32+2.62 x | 0.000 | 93.61 |
| PE | -0.413 | y=469.85-358.00 x | 0.000 | 104.66 |
| PA | 0.802 | y=3.81+658.98 x | 0.000 | 68.72 |
| PE/PA ratio | -0.778 | y=481.30-138.50 x | 0.000 | 72.23 |
| DT | 0.618 | y=-64.36+2.44 x | 0.000 | 90.37 |
The strongest univariate determinants of 6 MW test distance were Doppler-derived indices of LV diastolic filling. When the multivariate regression analysis was performed, only PA wave velocity (F to enter 192.71, multiple R = 0.79), PE/PA ratio (F to enter 115.22, multiple R = -0.37), and heart rate (F to enter 80.98, multiple R = -0.12) emerged as independent determinants of 6 MW test distance.
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