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Eur J Prev Cardiol. 2016 Oct;23(2 suppl):21-26.

Prognostic value of serial six-minute walk tests using tele-accelerometry in patients with chronic heart failure: A pre-specified sub-study of the TIM-HF-Trial.

Author information

1
Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany.
2
Kardiologische Praxis, Gerlingen, Germany.
3
Dr Oliver Hartmann Statistical Consulting, Frankfurt/Main, Germany.
4
Department of Internal Medicine/Cardiology, Unfallkrankenhaus Berlin, Germany.
5
Charité-Universitätsmedizin Berlin, Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin, Germany friedrich.koehler@charite.de.

Abstract

BACKGROUND:

The six-minute walk test (6MWT) is an established functional test assessing exercise capacity and is used to predict clinical prognosis in patients with chronic heart failure (HF). Tele-accelerometry is a novel approach to activity monitoring using telemedical data transfer and allows a Tele-6MWT to be performed in an outpatient setting. It offers patients the option of performing simple serial follow-up tests in their own home.

AIMS:

The aim of this study was to investigate the prognostic value of serial Tele-6MWTs using tele-accelerometry in patients with HF.

DESIGN/METHODS:

In this proof-of-concept study, 155 patients with HF completed the Tele-6MWT in an outdoor setting once per month over a period of 0.25-21 months. We analysed the differences in the number of steps over time to predict hospitalization as a result of HF or death.

RESULTS:

Patients with at least one event (n = 31) recorded a lower number of steps and a shorter distance in Tele-6MWT at baseline compared with patients who remained event-free (n = 124) (540.1 ± 78.4 steps vs. 601.8 ± 76.7 steps, P < 0.001 respectively; 353.2 ± 82.4 m vs. 418.8 ± 95.6 m, P < 0.001). Patients (n = 19) who performed more than one Tele-6MWT prior to a clinical event showed no significant difference in the number of steps, regardless of whether the baseline test was compared with the last Tele-6MWT before the event or with the last two tests before the event.

CONCLUSION:

Tele-6MWT has a high predictive value with respect to hospitalization as a result of HF or death from any cause and the results were comparable with the prognostic impact of a conventional 6MWT. Therefore Tele-6MWT may be used as alternative test method in the home environment. However, there is no added prognostic value of repeating Tele-6MWTs on a monthly basis.

KEYWORDS:

Six-minute walk test; TIM-HF; activity monitoring; heart failure; remote patient management; tele-accelerometry; telemedicine

PMID:
27892422
DOI:
10.1177/2047487316671438
[Indexed for MEDLINE]

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