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 .
Clinical and Neurohormonal Effects of Nicardipine Hydrochloride in Patients With Severe Chronic Heart Failure Receiving Angiotensin‐Converting Enzyme Inhibitor Therapy
It has been proposed that worsening of heart failure with dihydropyridines , such as nicardipine , is related to the activation of the neuroendocrine system . To test this , we evaluated 20 patients with severe heart failure ( mean age , 55 ± 13 years ; New York Heart Association functional class III ; left ventricular ejection fraction , 18 % ± 8 % on maintenance therapy with captopril , digoxin , and diuretics ) who were r and omized to nicardipine ( 60 or 90 mg/d ) or placebo during a 4-month double-blind protocol . The following measurements were obtained at baseline , monthly , and at 4 months or last follow-up visit : rest and exercise radionuclide ventriculography , maximal treadmill time , 6-minute walking test distance , serum norepinephrine and aldosterone concentrations , and plasma renin activity . During the follow-up period , worsening of heart failure occurred in 6 patients in the nicardipine group and in 2 patients in the placebo group ( p = 0.06 ) . The maximal treadmill time for a 6-minute walking distance and exercise radionuclide ejection fraction at the last follow-up visit did not change in patients who did not deteriorate with heart failure in the placebo or nicardipine groups as compared with baseline values . In this study group of patients with severe heart failure receiving therapy with digoxin , captopril , and diuretics , nicardipine was associated with worsening heart failure without an apparent activation of the neurohormones . However , because of the small number of patients and a significant number of patients who deteriorated during the follow-up period , no definitive conclusions can be made
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 .