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J Rheumatol. 2009 Jul;36(7):1481-5. doi: 10.3899/jrheum.081221. Epub 2009 Jun 1.

Lack of specificity of the 6-minute walk test as an outcome measure for patients with systemic sclerosis.

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  • 1Université Paris Descartes, Service de Rhumatologie A, Département de Cardiologie, and Service Physiologie et Explorations Fonctionnelles, Hôpital Cochin, AP-HP, 75014 Paris, France.

Abstract

OBJECTIVE:

The 6-minute walk test (6MWT) is an important prognostic tool in various cardiovascular diseases and has been considered as a surrogate endpoint. However, conflicting results have been reported in systemic sclerosis (SSc). Our objective was to evaluate the relationships of the 6-min walking distance (6MWD) and organ damage in SSc.

METHODS:

Eighty-seven consecutive patients with SSc were included and prospectively investigated; they underwent 6MWT in addition to conventional assessment of possible lung, heart, kidney, skin, and muscle involvement, and disease activity scoring, severity, and quality of life determination.

RESULTS:

Twenty-six patients (30%) had an abnormal 6MWT and the mean 6MWD was 461.8 +/- 103.0 m. When considering 6MWT as a binary variable - normal or abnormal - C-reactive protein (CRP) was the only independent variable associated with abnormal 6MWT. Considered as a continuous variable, the 6MWD was associated with measures of lung involvement and inflammation, with the activity and severity of disease, and also with quality of life; nevertheless, calcinosis was the only independent factor associated in multivariate analyses with a trend for an association for CRP.

CONCLUSION:

The 6MWD relates to broad factors in SSc and these results raise doubts about the specificity of the 6MWD in this systemic disease, and its relevance to monitoring therapy.

PMID:
19487260
[PubMed - indexed for MEDLINE]
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