Knowing how patients interpret changes in functional capacity is essential for translating
standardized measures such as the 6-minute-walk-test (6MWT) into a meaningful patient-reported
outcome (PRO). The 6MWT is a well-validated, commonly collected measure of exercise
capacity in heart failure (HF) clinical trials. However, it is often reduced to a
surrogate endpoint, whereby the clinical significance is defined solely by its relationship
to adverse outcomes such as death or hospitalization.
1
Alternatively, establishing a minimal clinically important difference (MCID) in the
6MWT that is anchored to a quality-of-life tool allows us to understand how much change
in functional status is meaningful to patients—a much more patient-centered and often
clinically relevant question.To read this article in full you will need to make a payment
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References
- Functional and symptomatic clinical trial endpoints: the HFC-ARC Scientific Expert Panel.JACC Heart Fail. 2022; 10: 889-901
- Minimal clinically important differences in 6-minute walk test in patients with HFrEF and iron deficiency.J Card Fail. 2022; (S1071-9164(22)01173-3Epub ahead of print. PMID: 36332897)https://doi.org/10.1016/j.cardfail.2022.10.423
- Ferric carboxymaltose in patients with heart failure and iron deficiency.N Engl J Med. 2009; 361: 2436-2448
- Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency.Eur Heart J. 2015; 36: 657-668
- Triangulating clinically meaningful change in the six-minute walk test in individuals with chronic heart failure: a systematic review.Cardiopulm Phys Ther J. 2012; 23: 5-15
- Reliability, construct validity and determinants of 6-minute walk test performance in patients with chronic heart failure.Int J Cardiol. 2017; 240: 285-290
- Clinimetrics corner: a closer look at the minimal clinically important difference (MCID).J Man Manip Ther. 2012; 20: 160-166
- Monitoring clinical changes in patients with heart failure: a comparison of methods.Am Heart J. 2005; 150: 707-715
- HEART-FID Trial Investigators.Randomized placebo-controlled trial of ferric carboxymaltose in heart failure with iron deficiency: rationale and design.Circ Heart Fail. 2021; 14 (Epub 2021 May 18. PMID: 34003690; PMCID: PMC8136455)e008100https://doi.org/10.1161/CIRCHEARTFAILURE.120.008100
Article info
Publication history
Published online: January 19, 2023
Accepted:
January 12,
2023
Received:
January 12,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
ScienceDirect
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- Minimal Clinically Important Differences in 6-Minute Walk Test in Patients With HFrEF and Iron DeficiencyJournal of Cardiac Failure
- PreviewImpaired functional capacity is common in patients with heart failure (HF).1 With increasing focus on patient preference for better overall health status, in addition to a reduction in the use of traditional disease-specific endpoints, such as morbidity and mortality,2,3 therapeutic targets in patients with HF have expanded to encompass improvements in functional capacity and health status (health-related quality of life).4 The 6-minute walk test (6MWT) is an indicator of exercise capacity and prognosis in various cardiopulmonary conditions.
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