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 .
Dose-response of chronic beta-blocker treatment in heart failure from either idiopathic dilated or ischemic cardiomyopathy. Bucindolol Investigators.
BACKGROUND Small-scale clinical investigations have demonstrated that single doses of beta-blocking agents can improve left ventricular function in heart failure from idiopathic dilated cardiomyopathy ( IDC ) . The purpose of this multicenter clinical trial was to determine the dose-effect characteristics of beta-blockade in a heart failure population that includes ischemic dilated cardiomyopathy ( ISCD ) . METHODS AND RESULTS Bucindolol is a nonselective beta-blocking agent with mild vasodilatory properties . One hundred forty-one subjects with class II or III heart failure , left ventricular ejection fraction ( LVEF ) < or = 0.40 , and background therapy of angiotensin-converting enzyme inhibitors , digoxin , and diuretics were given an initial challenge dose of bucindolol 12.5 mg . One hundred thirty-nine subjects ( 99 with IDC , 40 with ISCDC ) tolerated challenge and were r and omized to treatment with placebo or bucindolol 12.5 mg/d ( low dose ) , 50 mg/d ( medium dose ) , or 200 mg/d ( high dose ) . At the end of 12 weeks , left ventricular function and other parameters were measured and compared with baseline values . There was a dose-related improvement in left ventricular function in bucindolol-treated subjects . In the high-dose bucindolol group , radionuclide-measured LVEF improved by 7.8 EF units ( % ) compared with 1.8 units in the placebo group ( P < .05 ) , and compared with the placebo group , a greater percentage of subjects had an increase in LVEF by > or = 5 units . In contrast , all three bucindolol doses prevented deterioration of myocardial function as defined by an LVEF decline of > or = 5 units . CONCLUSIONS In heart failure from systolic dysfunction , beta-blockade with bucindolol produces a dose-related improvement in and prevents deterioration of left ventricular function
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 .