Pharmacological trials including patients with more severe heart failure were more likely to show a significant improvement with therapy than trials of milder heart failure .
Using mean values in these trials , the age of patients appeared a more important determinant of 6MWT distance than New York Heart Association classification .
The 6MWT has not yet been proven to be a robust test for the identification of effective pharmacological interventions although it appears useful for the assessment of cardiac resynchronization therapy .
The results of the 6MWT were concordant with changes in symptoms , suggesting that it may be used as supportive evidence for symptom benefit .
AIMS The 6 min walk test ( 6MWT ) is commonly used in clinical trials to assess treatments for heart failure , but its ability to distinguish between effective and ineffective treatments is question able .
The aim of this study is to investigate , using a systematic literature review , the utility of the 6MWT as a measure of the effectiveness of treatment in r and omized controlled trials of heart failure .
Randomized trial of candesartan cilexetil in the treatment of patients with congestive heart failure and a history of intolerance to angiotensin-converting enzyme inhibitors.
BACKGROUND Many patients with congestive heart failure do not receive the benefits of angiotensin-converting enzyme ( ACE ) inhibitors because of intolerance . We sought to determine the tolerability of an angiotensin II receptor blocker , c and esartan cilexetil , among patients considered intolerant of ACE inhibitors . METHODS Patients with CHF , left ventricular ejection fraction less than 35 % , and history of discontinuing an ACE inhibitor because of intolerance underwent double-blind r and omization in a 2:1 ratio to receive c and esartan ( n = 179 ) or a placebo ( n = 91 ) . The initial dosage of c and esartan was 4 mg/d ; the dosage was increased to 16 mg/d if the drug was tolerated . A history of  intolerance of ACE inhibitor was attributed to cough ( 67 % of patients ) , hypotension ( 15 % ) , or renal dysfunction ( 11 % ) . RESULTS The study drug was continued for 12 weeks by 82.7 % of patients who received c and esartan versus 86.8 % of patients who received the placebo . This 4.1 % greater discontinuation rate with active therapy was not significant ; the 95 % confidence interval ranged from 4.8 % more discontinuation with placebo to 13 % more with c and esartan . Titration to the 16-mg target dose was possible for 69 % of patients who received c and esartan versus 84 % of those who received the placebo .  Frequencies of death and morbidity were not significantly different between the c and esartan and placebo groups ( death 3.4 % and 3.3 % , worsening heart failure 8.4 % and 13.2 % , myocardial infa rct ion 2.8 % and 5.5 % , all-cause hospitalization 12.8 % and 18.7 % , and death or hospitalization for heart failure 11.7 % and 14.3 % ) . CONCLUSIONS C and esartan was well tolerated by this population . The effect of c and esartan on major clinical end points , including death , remains to be determined
Pharmacological trials including patients with more severe heart failure were more likely to show a significant improvement with therapy than trials of milder heart failure .
Using mean values in these trials , the age of patients appeared a more important determinant of 6MWT distance than New York Heart Association classification .
The 6MWT has not yet been proven to be a robust test for the identification of effective pharmacological interventions although it appears useful for the assessment of cardiac resynchronization therapy .
The results of the 6MWT were concordant with changes in symptoms , suggesting that it may be used as supportive evidence for symptom benefit .
AIMS The 6 min walk test ( 6MWT ) is commonly used in clinical trials to assess treatments for heart failure , but its ability to distinguish between effective and ineffective treatments is question able .
The aim of this study is to investigate , using a systematic literature review , the utility of the 6MWT as a measure of the effectiveness of treatment in r and omized controlled trials of heart failure .