Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The prognostic significance of the 6-minute walk distance (6MWD) in patients with severe aortic stenosis (AS) has not been thoroughly investigated. METHODS AND RESULTS: This study evaluated 998 patients with severe AS who underwent a 6-min walk test as part of a large multicenter prospective cohort. Patients were categorized as either fast walkers (6MWD ≥300 m; n=515) or slow walkers (6MWD <300 m; n=483). During a median follow-up of 2.3 years, 861 (86.3%) patients underwent surgical or transcatheter aortic valve replacement (AVR; 87.0% of fast walkers vs. 85.5% of slow walkers). The cumulative 3-year incidence of death was significantly lower among fast walkers than slow walkers (10.9% vs. 31.7%; P<0.001). After adjusting for confounders, slow walkers had a significantly higher risk of all-cause mortality than fast walkers (hazard ratio 2.36; 95% confidence interval 1.55-3.58; P<0.001). Stratified analysis by initial treatment strategy revealed that the cumulative 3-year incidence of all-cause death was consistently lower among fast walkers than slow walkers (initial AVR strategy: 10.1% vs. 28.1% [P<0.001]; conservative strategy: 13.4% vs. 46.7% [P<0.001]). Among asymptomatic patients managed conservatively, fast walkers demonstrated a remarkably low cumulative 3-year incidence of all-cause death (8.1%). CONCLUSIONS: The 6MWD is a reliable prognostic marker for patients with severe AS, regardless of initial treatment strategy.
Source: Circulation Journal
Authors: Norio Kanamori, Yasuaki Takeji, Tomohiko Taniguchi, Takeshi Morimoto, Shinichi Shirai, Kenji Ando, Hiroyuki Tabata, Takeshi Kitai, Nobuhisa Ohno, Ryosuke Murai, Kohei Osakada, Koichiro Murata, Masanao Nakai, Hiroshi Tsuneyoshi, Tomohisa Tada, Masashi Amano, Shin Watanabe, Hiroki Shiomi, Hirotoshi Watanabe, Yusuke Yoshikawa, Ryusuke Nishikawa, Yuki Obayashi, Ko Yamamoto, Mamoru Toyofuku, Shojiro Tatsushima, Makoto Miyake, Hiroyuki Nakayama, Kazuya Nagao, Masayasu Izuhara, Kenji Nakatsuma, Moriaki Inoko, Takanari Fujita, Masahiro Kimura, Mitsuru Ishii, Shunsuke Usami, Fumiko Nakazeki, Kiyonori Togi, Yasutaka Inuzuka, Tatsuhiko Komiya, Koh Ono, Takeshi Aoyama, Kenji Minatoya, Takeshi Kimura, on behalf of the CURRENT AS Registry-2 Investigators
Institutions: Shimada Municipal Hospital, Kanazawa University, Kyoto University, Kobe City Medical Center General Hospital, Hyogo Medical University, Kokura Memorial Hospital, National Cerebral and Cardiovascular Center, Kurashiki Central Hospital, Shizuoka City Hospital, Shizuoka General Hospital, Hirakata Kohsai Hospital, Japanese Red Cross Society Wakayama Medical Center, Tenri Hospital, Hyogo Prefectural Amagasaki General Medical Center, Osaka Red Cross Hospital, Kishiwada City Hospital, Mitsubishi Kyoto Hospital, Kitano Hospital, Koto Hospital, Koto Memorial Hospital, Kyoto Medical Center, Kansai Electric Power (Japan), Kansai Electric Power Hospital, Otsu Red Cross Hospital, Kindai University Nara Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funders: Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Edwards Lifesciences, CSL Behring, Boston Scientific Corporation, Japan Lifeline, Kowa Company, Nipro, Abiomed, Eisai, Astellas Pharma, Otsuka Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical, Novartis Pharma, Chugai Pharmaceutical, Abbott Vascular, Japan Society for the Promotion of Science, Daiichi Sankyo Europe
OpenAlex ID: W4410530751