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 .
Comparative effects of losartan and enalapril on exercise capacity and clinical status in patients with heart failure. The Losartan Pilot Exercise Study Investigators.
OBJECTIVES This study was design ed to determine 1 ) whether 12-week oral administration of losartan , an angiotensin II receptor antagonist , in patients with heart failure is well tolerated ; and 2 ) whether functional capacity and clinical status of patients with heart failure in whom treatment with an angiotensin-converting enzyme ( ACE ) inhibitor is replaced with losartan for 12 weeks will remain similar to that noted in patients in whom treatment with an ACE inhibitor is continued . BACKGROUND Losartan is a specific , nonpeptide angiotensin II receptor antagonist . Although specific receptor blockade with losartan has certain theoretic advantages over nonspecific ACE inhibition , definitive demonstration of comparable effects in patients with congestive heart failure is lacking . METHODS A double-blind , multicenter , r and omized , parallel , enalapril-controlled study was conducted in 116 patients with congestive heart failure ( New York Heart Association functional classes II to IV ) and left ventricular ejection fraction < or = 45 % previously treated with stable doses of ACE inhibitors and diuretic agents , with or without concurrent digitalis and other vasodilators .  After a baseline exercise period , open-label ACE inhibitors were discontinued , and patients were r and omly assigned to 12 weeks of therapy with losartan , 25 mg/day ( n = 38 ) ; losartan , 50 mg/day ( n = 40 ) ; or enalapril , 20 mg/day ( n = 38 ) . Drug efficacy was evaluated by changes in maximal treadmill exercise time ( using a modified Naughton protocol ) , 6-min walk test , left ventricular ejection fraction and dyspnea-fatigue index . Safety was measured by the incidence of clinical and laboratory adverse experiences . RESULTS The treadmill exercise time and the 6-min walk test did not change significantly after replacement of ACE inhibitor therapy with losartan . Similarly , a significant change was not observed in either the dyspnea-fatigue index or left ventricular ejection fraction at the end of double-blind period relative to baseline . CONCLUSIONS Losartan was generally well tolerated and comparable to enalapril in terms of exercise tolerance in this short-term ( 12-week ) study of patients with heart failure . The clinical effects of long-term angiotensin II receptor blockade compared with ACE inhibition remain to be studied
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 .