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Prognostic value of preprocedural 6-min walk test in patients undergoing transcatheter mitral valve repair—insights from the German transcatheter mitral valve interventions registry

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Abstract

Aims

The 6-min walk test (6 MWT) has been established as an important tool for functional assessment in heart failure patients. However, its prognostic impact on the outcome in subjects with mitral regurgitation undergoing transcatheter mitral valve repair is unknown.

Methods

This present work represents a sub-analysis of the German, prospective, multicenter, Transcatheter Mitral Valve Interventions (TRAMI) registry. Of the main study cohort (n = 828) 326 patients underwent 6 MWT prior to the procedure. Patients were assigned to two groups depending on the preprocedural 6 MWT distance using the median (< 200 m [group 1] vs. ≥ 200 m [group 2]).

Results

No differences regarding procedural success (97 vs. 96%; p = 0.71) and 30-day mortality (3 vs. 4%; p = 0.96) were observed between the groups. With regards to 1-year outcome, patients with a walking distance < 200 m had higher all-cause mortality (26 vs. 14%; p = 0.013) as compared to those with a 6 MWT distance 200 m. After adjustment of baseline risk factors, 6 MWT distance < 200 m still showed a strong trend towards increased 1-year all-cause mortality (HR 1.63, 95% confidence interval 0.96–2.76; p = 0.071).

Conclusions

In the present study preprocedural 6 MWT distance < 200 m showed a strong trend towards increased 1-year mortality in patients undergoing MitraClip implantation.

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Abbreviations

6 MWT:

Six minute walk test

IHF:

Institut für Herzinfarktforschung

MR:

Mitral regurgitation

NT-pro-BNP:

N-terminal pro-brain natriuretic peptide

NYHA:

New York Heart Association

STS:

Society of Thoracic Surgeons

TRAMI:

Transcatheter Mitral Valve Interventions

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Authors and Affiliations

  1. CardioVascular Center Frankfurt, Seckbacher Landstraße 65, 60389, Frankfurt, Germany

    Jakob Ledwoch & Horst Sievert

  2. Universitäres Herzzentrum Eppendorf, Hamburg, Germany

    Jennifer Franke & Edith Lubos

  3. Klinik für Kardiologie und Angiologie, Klinikum Siegburg, Siegburg, Germany

    Peter Boekstegers

  4. Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany

    Miriam Puls

  5. Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany

    Taoufik Ouarrak & Jochen Senges

  6. Medizinische Klinik, Universitätsmedizin Mainz, Mainz, Germany

    Stephan von Bardeleben

  7. Herzzentrum Brandenburg, Bernau, Germany

    Christian Butter

  8. Medizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer GmbH, Hamburg, Germany

    Joachim Schofer

  9. Herzzentrum Ludwigshafen, Ludwigshafen, Germany

    Ralf Zahn

  10. Universitätsklinik Rostock, Rostock, Germany

    Hüsseyin Ince

  11. Anglia Ruskin University, Chelmsford, UK

    Horst Sievert

Authors
  1. Jakob Ledwoch
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  2. Jennifer Franke
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  12. Jochen Senges
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  13. Horst Sievert
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Corresponding author

Correspondence to Horst Sievert.

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Conflict of interest

Jakob Ledwoch: none. Jennifer Franke: none. Edith Lubos: Speakers honoraria, research funding and traveling expenses from Abbott Vascular. Peter Boekstegers: none. Miriam Puls: Travel expenses from Abbott Vascular. Taoufik Ouarrak: none. Stephan von Bardeleben: Speakers honoria and research grant from Abbott Vascular. Christian Butter: none. Joachim Schofer: none. Ralf Zahn: none. Hüsseyin Ince: Proctor for Abbott Vascular. Jochen Senges: none. Horst Sievert: Study honorary, travel expenses, consulting fees from Access Closure, AGA, Angiomed, Ardian, Arstasis, Atritech, Atrium, Avinger, Bard, Boston Scientific, Bridgepoint, CardioKinetix, CardioMEMS, Coherex, Contego, CSI, EndoCross, EndoTex, Epitek, Evalve, ev3, FlowCardia, Gore, Guidant, Lumen Biomedical, HLT, Kensey Nash, Kyoto Medical, Lifetech, Lutonix, Medinol, Medtronic, NDC, NMT, OAS, Occlutech, Osprey, Ovalis, Pathway, PendraCare, Percardia, pfm Medical, Recor, Rox Medical, Sadra, Sorin, Spectranetics, SquareOne, Trireme, Trivascular, Viacor, Velocimed, Veryan. Stock options from Cardiokinetix, Access Closure, Velocimed, CoAptus, Lumen Biomedical, Coherex.

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Ledwoch, J., Franke, J., Lubos, E. et al. Prognostic value of preprocedural 6-min walk test in patients undergoing transcatheter mitral valve repair—insights from the German transcatheter mitral valve interventions registry. Clin Res Cardiol 107, 241–248 (2018). https://doi.org/10.1007/s00392-017-1177-z

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  • DOI: https://doi.org/10.1007/s00392-017-1177-z

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