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 metoprolol in idiopathic dilated cardiomyopathy
Several small studies have suggested beneficial effects of long-term beta-blocker treatment in idiopathic dilated cardiomyopathy . Our large multicentre study aim ed to find out whether metoprolol improves overall survival and morbidity in this disorder . 383 subjects with heart failure from idiopathic dilated cardiomyopathy ( ejection fraction < 0.40 ) were r and omly assigned placebo or metoprolol . 94 % were in New York Heart Association functional classes II and III , and 80 % were receiving background treatment . A test dose of metoprolol ( 5 mg twice daily ) was given for 2 - 7 days ; those tolerating this dose ( 96 % ) entered r and omisation . Study medication was increased slowly from 10 mg to 100 - 150 mg daily . There were 34 % ( 95 % CI -6 to 62 % , p = 0.058 ) fewer primary endpoints in the metoprolol than the placebo group ; 2 and 19 patients , respectively , deteriorated to the point of needing transplantation and 23 and 19 died . The change in ejection fraction from baseline to 12 months was significantly greater with metoprolol than with placebo ( 0.13 vs 0.06 , p < 0.0001 ) . Pulmonary capillary wedge pressure decreased more from baseline to 12 months with metoprolol than with placebo ( 5 vs 2 mm Hg , p = 0.06 ) . Exercise time at 12 months was significantly greater ( p = 0.046 ) in metoprolol-treated than in placebo-treated patients . In patients with idiopathic dilated cardiomyopathy , treatment with metoprolol prevented clinical deterioration , improved symptoms and cardiac function , and was well tolerated
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 .