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 .
Controlled Trial of Intravenous Immune Globulin in Recent-Onset Dilated Cardiomyopathy
Background This prospect i ve placebo-controlled trial was design ed to determine whether intravenous immune globulin ( IVIG ) improves left ventricular ejection fraction ( LVEF ) in adults with recent onset of idiopathic dilated cardiomyopathy or myocarditis . Methods and Results Sixty-two patients ( 37 men , 25 women ; mean age ±SD 43.0±12.3 years ) with recent onset ( ≤6 months of symptoms ) of dilated cardiomyopathy and LVEF ≤0.40 were r and omized to 2 g/kg IVIG or placebo .  All underwent an  endomyocardial biopsy  before r and omization , which revealed cellular inflammation in 16 % . The primary outcome was change in LVEF at 6 and 12 months after r and omization . Overall , LVEF improved from 0.25±0.08 to 0.41±0.17 at 6 months ( P < 0.001 ) and 0.42±0.14 ( P < 0.001 versus baseline ) at 12 months . The increase was virtually identical in patients receiving IVIG and those given placebo ( 6 months : IVIG 0.14±0.12 , placebo 0.14±0.14 ; 12 months : IVIG 0.16±0.12 , placebo 0.15±0.16 ) . Overall , 31 ( 56 % ) of 55 patients at 1 year had an increase in LVEF ≥0.10 from study entry , and 20 ( 36 % ) of 56 normalized their ejection fraction ( ≥0.50 ) . The transplant-free survival rate was 92 % at 1 year and 88 % at 2 years . Conclusions These results suggest that for patients with recent-onset dilated cardiomyopathy  , IVIG does not augment the improvement in LVEF . However , in this overall cohort , LVEF improved significantly during follow-up , and the short-term prognosis remains favorable
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 .