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 .
Beneficial effects of statins in patients with non-ischemic heart failure
Experimentelle Arbeiten und retrospektive Analysen klinischer Studien lassen einen positiven Effekt von Statinen bei Patienten mit Herzinsuffizienz vermuten . Möglicherweise ist hieran eine direkte Wirkung von Statinen auf das Myokard beteiligt . Wir untersuchten daher in einer prospektiven , r and omisierten , doppelblinden Studie ( n = 15 ) den Effekt von Cerivastatin 0,4 mg ( Statin ) oder Placebo auf Patienten mit nichtischämischer Kardiomyopathie . Einschlusskriterien waren der angiographische Ausschluss von Koronarstenosen , stabile Herzinsuffizienz NYHA II-IV und eine etablierte Therapie mit ACE-Hemmern und Betablockern . Die Beh and lungsdauer betrug i m Mittel 20 Wochen . Die Statinbeh and lung führte bei den normo- cholesterinämischen Patienten zu einer Reduktion des LDL um 11,3 mg/dl ( p = n. s. ) . Es zeigte sich eine Verbesserung der Lebensqualität und der körperlichen Belastbarkeit in der Statin- , aber nicht in der Placebo Gruppe . Dies war assoziiert mit einem Trend zu einer verbesserten linksventrikulären Pumpfunktion und einer gesteigerten Endothel-abhängigen Vasodilatation . Die Statin Beh and lung führte i m Vergleich zu Placebo zu einer signifikanten Herabregulation der Plasmakonzentrationen von Troponin T , hochsensitivem CRP , Plasminogen Aktivator Inhibitor und Tumor Nekrose Faktor alpha , dagegen wurden ICAM-1 und IL-10 nicht signifikant reguliert . Statine zeigen positive Effekte bei Patienten mit nicht-ischämischer Kardiomyopathie und verbessern die Lebensqualität und die körperliche Belastbarkeit . Diese Pilotstudie könnte auf eine neue Beh and lungsstrategie für Patienten mit Herzinsuffizienz hinweisen . HMG CoA reductase inhibitors ( statins ) may exert a wide array of cholesterolindependent effects including antihypertrophic effects on the heart . Their role in the treatment of heart failure has not been studied . 15 patients with heart failure NYHA II-III based on non-ischemic dilated cardiomyopathy were r and omized in a double-blind study to 0.4 mg cerivastatin or placebo for an average treatment period of 20 weeks .  Quality of life and exercise capacity increased significantly in the statin treatment but not in the placebo group ( Minnesota Living with Heart Failure Question naire , 6 min walking test ) . Concomitantly , there was a trend towards increased left ventricular ejection fraction ( radionuclear ventriculography ) and improved endothelial function ( forearm blood flow ) . Statins  decreased plasma concentrations of troponine T , high sensitive C-reactive protein ( hsCRP ) , plasminogen activator inhibitor-1 ( PAI-1 ) and tumor necrosis factor alpha ( TNFα ) . Statins induce benefical effects in patients with non-ischemic cardiomyopathy leading to improvement of quality of life and exercise capacity disclosing a promising novel treatment strategy for patients with heart failure
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 .