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 .
Effects of metoprolol CR in patients with ischemic and dilated cardiomyopathy : the randomized evaluation of strategies for left ventricular dysfunction pilot study.
BACKGROUND Metoprolol provides clinical benefits in patients with congestive heart failure ( CHF ) . In this study , we investigated the effects of controlled-release metoprolol ( metoprolol CR ) on clinical status , on left ventricular ( LV ) volumes and function , and on neurohumoral activation in a large number of patients with CHF of mixed causes . METHODS AND RESULTS Four hundred twenty-six patients with symptomatic CHF were r and omized to receive metoprolol CR or placebo for 24 weeks . Metoprolol CR did not affect 6-minute walk distance , New York Heart Association functional class , or quality of life . However , there was a significant improvement in measures of LV function with an attenuation in the increase in LV end-diastolic ( + 23+/-65 mL [ placebo ] versus + 6+/-61 mL , P=0.01 ) and LV end-systolic ( + 19+/-55 mL [ placebo ] versus -2+/-51 mL , P<0.001 ) volumes after 24 weeks of therapy . LV ejection fraction was unchanged ( -0.05 % or -0.005 ) in the placebo group but increased by 2 . 4 % in the metoprolol CR-treated patients ( P=0.001 ) . Patients receiving metoprolol CR had a greater decrease in angiotensin II ( P=0.036 ) and renin ( P=0.032 ) levels but an increase in N-terminal atrial natriuretic peptide and brain natriuretic peptide levels ( P<0 . 01 ) . There were fewer deaths in the group receiving beta-blockers ( 3 . 4 % versus 8.1 % ) , and there was a similar number of patients experiencing the composite outcomes of death or any hospitalization . CONCLUSIONS When added to ACE inhibitors , angiotensin II receptor antagonists , or both , the use of metoprolol CR improves ventricular function , reduces activation of the renin-angiotensin systems , and results in fewer deaths
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 .