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 .
Reproducibility of the six-minute walking test in chronic heart failure patients.
The six-minute walking test ( WT ) is used in trials and clinical practice as an easy tool to evaluate the functional capacity of chronic heart failure ( CHF ) patients . As WT measurements are highly variable both between and within individuals , this study aims at assessing the contribution of the different sources of variation and estimating the reproducibility of the test . A statistical model describing WT measurements as a function of fixed and r and om effects is proposed and its parameters estimated . We considered 202 stable CHF patients who performed two baseline WTs separated by a 30 minute rest ;  49 of them repeated the two tests 3 months later ( follow-up control ) . They had no changes in therapy or major clinical events . Another 31 subjects performed two baseline tests separated by 24 hours . Collected data were analysed using a mixed model methodology . There was no significant difference between measurements taken 30 minutes and 24 hours apart ( p = 0.99 ) . A trend effect of 17 ( 1.4 ) m ( mean ( SE ) ) was consistently found between duplicate tests ( p < 0.001 ) . REML estimates of variance components were : 5189 ( 674 ) for subject differences in the error-free value ; 1280 ( 304 ) for subject differences in spontaneous clinical evolution between baseline and follow-up control , and 266 ( 23 ) for the within-subject error . Hence , the st and ard error of measurement was 16.3 m , namely 4 per cent of the average WT performance ( 403 m ) in this sample . The intraclass correlation coefficient was 0.96 . We conclude that WT measurements are characterized by good intrasubject reproducibility and excellent reliability . When follow-up studies > or = 3 months are performed , unpredictable changes in individual walking performance due to spontaneous clinical evolution are to be expected . Their clinical significance , however , is not known
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 .