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 .
Symptomatic improvement in patients treated with intermittent infusion of inotropes: a double-blind placebo controled pilot study.
The safety and benefit of outpatient inotrope infusions in intractable heart failure remains controversial . Accordingly a prospect i ve double blind , crossover r and omization scheme was utilized in stable patients with heart failure but intractable symptoms . A total of 29 patients ( mean age 66 + /- 13 years , with a mean left ventricular systolic function of 18 + /- 9 % , New York Heart Association class 3.6 + /- 0.5 ) met all the inclusion and none of the exclusion criteria to receive  intravenous milrinone , dobutamine , or matching placebo .  Safety evaluations including routine laboratory studies , physical examinations , electrocardiographic monitoring , vital signs , assessment of quality of life scores using the Minnesota Living with Heart Failure question naire , six-minute walk tests , and echocardiographic assessment s were performed . All 29 patients completed the weaning protocol without adverse events ( mean of 27.3 + /- 11.8 treatments per patient ) . Patients initially assigned to milrinone received fewer treatment sessions ( 19 + /- 8 versus 31 + /- 12 ( dobutamine ) and 33 + /- 10 ( placebo ) ; p<0.02 . Furthermore , only 10 % of the patients treated with milrinone required crossover r and omization compared to 27 % patients assigned to dobutamine and 75 % patients assigned to placebo . A statistically significant reduction in quality of life scores ( 60 + /- 20 versus 35 + /- 18 ; p < 0.00001 ) with an increase in 6-minute walk test assessment s ( 959 + /- 431 versus 1269 + /- 469 ; p < 0.01 ) was noted . Most importantly , in patients assigned to inotropes a 23 % increase in 6-minute walk test scores was noted at the end of the study when compared to baseline scores . In contrast , a reduction of -1 % ( p < 0.001 ) was noted in patients assigned to placebo . Finally , a trend that although did not reached statistical significance was noted in patients assigned to milrinone in terms of improvement in left ventricular systolic function , reduction in the severity of mitral regurgitation and estimated right ventricular systolic pressure . These results demonstrate that outpatient infusion of inotropes appear to be safe and effective in improving heart failure symptoms , reducing need for hospitalizations and emergency room visits . Furthermore , infusion of inotropes result ed in a significant improvement on 6-minute walk test scores than placebo . It also appears that milrinone confers all these benefits sooner than dobutamine
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 .