An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients

Background: As cardio-vascular diseases are the leading cause of death worldwide, establishing measures to improve cardiovascular health is of crucial importance. Exercise plays an essential role in cardiac rehabilitation of patients with coronary artery disease (CAD), in whom an evaluation of the c...

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Main Authors: Helena Lenasi, Ana Novak, Borut Jug, Edvin Dervišević, Damir Karpljuk, Mateja Videmšek, Maroje Sorić, Vedran Hadžić
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-03-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2022.844847/full
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author Helena Lenasi
Ana Novak
Borut Jug
Edvin Dervišević
Damir Karpljuk
Mateja Videmšek
Maroje Sorić
Vedran Hadžić
author_facet Helena Lenasi
Ana Novak
Borut Jug
Edvin Dervišević
Damir Karpljuk
Mateja Videmšek
Maroje Sorić
Vedran Hadžić
author_sort Helena Lenasi
collection DOAJ
description Background: As cardio-vascular diseases are the leading cause of death worldwide, establishing measures to improve cardiovascular health is of crucial importance. Exercise plays an essential role in cardiac rehabilitation of patients with coronary artery disease (CAD), in whom an evaluation of the cardiorespiratory fitness (CRF) is necessary. CRF of CAD patients could be assessed using 6-min walk test (6MWT), and the results interpreted by using Enright-Sherill prediction equation which has mainly been designed and evaluated for a healthy population. Hypothesizing that the Enright-Sherill prediction equation might not be best suited for CAD patients, our aim was to reevaluate this equation in CAD patients, and potentially establish a more accurate 6MWD prediction equation to be applied in these patients.Methods: 6MWD was measured in a cross-sectional study in 67 CAD patients (44 women) who were members of the Coronary club Ljubljana, Slovenia. In addition, the predicted 6MWD was calculated for men and women using Enright-Sherill gender specific regression equation. Multivariate regression analysis was used to obtain a new prediction equation, and the agreement between the measured and the predicted 6MWD analyzed using the repeated measures ANOVA.Results: Men achieved 451 ± 122 m and women 485 ± 69 m without significant differences between sexes (F = 0.022, p = 0.882) when adjusted for age, height, body mass, and waist circumference. When comparing the measured (473 ± 91 m) and the predicted (422 ± 57 m) values of 6MWD in CAD patients we found that the Enright-Sherill prediction equation significantly (F = 27.734, p < 0.001) underestimated the 6MWD by 52 ± 81 m. A significant regression equation was established [F (3,63) = 44.663, p < 0.001], with a R2 of 0.680 where 6MWD equals 1,057 m—4.966 x age (years)—0.614 x WC (cm)–68.629 x NYHA class.Conclusion: The results of this study stress the importance of regular and actual walking ability testing in patients with stable CAD to obtain their CRF, rather than simply predicting it from regression equations obtained from non-representative or non-comparable samples. Our developed prediction equation warrants additional validation and may represent a good substitute for currently used predictions obtained from a healthy population.
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spelling doaj.art-b9a3246f776c4a7abe9050feb12ef0c12022-12-21T21:19:15ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-03-011310.3389/fphys.2022.844847844847An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease PatientsHelena Lenasi0Ana Novak1Borut Jug2Edvin Dervišević3Damir Karpljuk4Mateja Videmšek5Maroje Sorić6Vedran Hadžić7Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaSports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaDepartment of Vascular Diseases, Division of Internal Medicine, University Medical Center, Ljubljana, SloveniaSports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaSports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaSports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaDepartment of Sport and Exercise Medicine, Faculty of Kinesiology, University of Zagreb, Zagreb, CroatiaSports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, SloveniaBackground: As cardio-vascular diseases are the leading cause of death worldwide, establishing measures to improve cardiovascular health is of crucial importance. Exercise plays an essential role in cardiac rehabilitation of patients with coronary artery disease (CAD), in whom an evaluation of the cardiorespiratory fitness (CRF) is necessary. CRF of CAD patients could be assessed using 6-min walk test (6MWT), and the results interpreted by using Enright-Sherill prediction equation which has mainly been designed and evaluated for a healthy population. Hypothesizing that the Enright-Sherill prediction equation might not be best suited for CAD patients, our aim was to reevaluate this equation in CAD patients, and potentially establish a more accurate 6MWD prediction equation to be applied in these patients.Methods: 6MWD was measured in a cross-sectional study in 67 CAD patients (44 women) who were members of the Coronary club Ljubljana, Slovenia. In addition, the predicted 6MWD was calculated for men and women using Enright-Sherill gender specific regression equation. Multivariate regression analysis was used to obtain a new prediction equation, and the agreement between the measured and the predicted 6MWD analyzed using the repeated measures ANOVA.Results: Men achieved 451 ± 122 m and women 485 ± 69 m without significant differences between sexes (F = 0.022, p = 0.882) when adjusted for age, height, body mass, and waist circumference. When comparing the measured (473 ± 91 m) and the predicted (422 ± 57 m) values of 6MWD in CAD patients we found that the Enright-Sherill prediction equation significantly (F = 27.734, p < 0.001) underestimated the 6MWD by 52 ± 81 m. A significant regression equation was established [F (3,63) = 44.663, p < 0.001], with a R2 of 0.680 where 6MWD equals 1,057 m—4.966 x age (years)—0.614 x WC (cm)–68.629 x NYHA class.Conclusion: The results of this study stress the importance of regular and actual walking ability testing in patients with stable CAD to obtain their CRF, rather than simply predicting it from regression equations obtained from non-representative or non-comparable samples. Our developed prediction equation warrants additional validation and may represent a good substitute for currently used predictions obtained from a healthy population.https://www.frontiersin.org/articles/10.3389/fphys.2022.844847/fullcardiac rehabilitation (CR)coronary artery diseasecardiorespiratory fitness (CRF)six-minute walk test (6MWT)six-minute walk distance (6MWD)NYHA class
spellingShingle Helena Lenasi
Ana Novak
Borut Jug
Edvin Dervišević
Damir Karpljuk
Mateja Videmšek
Maroje Sorić
Vedran Hadžić
An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
Frontiers in Physiology
cardiac rehabilitation (CR)
coronary artery disease
cardiorespiratory fitness (CRF)
six-minute walk test (6MWT)
six-minute walk distance (6MWD)
NYHA class
title An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
title_full An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
title_fullStr An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
title_full_unstemmed An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
title_short An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients
title_sort alternative prediction equation for evaluation of six minute walk distance in stable coronary artery disease patients
topic cardiac rehabilitation (CR)
coronary artery disease
cardiorespiratory fitness (CRF)
six-minute walk test (6MWT)
six-minute walk distance (6MWD)
NYHA class
url https://www.frontiersin.org/articles/10.3389/fphys.2022.844847/full
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