JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Reesink, H. J.
Right arrow Articles by Bresser, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Reesink, H. J.
Right arrow Articles by Bresser, P.
Related Collections
Right arrow Cardiac - physiology

J Thorac Cardiovasc Surg 2007;133:510-516
© 2007 The American Association for Thoracic Surgery


Cardiopulmonary Support and Physiology

Six-minute walk distance as parameter of functional outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension

Herre J. Reesink, MDa, Mart N. van der Plas, MSc, RFTa, Niesje E. Verhey, RFTa, Reindert P. van Steenwijk, MDa, Jaap J. Kloek, MDb, Paul Bresser, MD, PhDa,*

a Department of Pulmonology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
b Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

Received for publication June 13, 2006; revisions received October 2, 2006; accepted for publication October 9, 2006.

* Reprint requests: Paul Bresser, MD, PhD, Academic Medical Centre, University of Amsterdam, Department of Pulmonology, F5-144, PO Box 22700, 1100 DE Amsterdam, The Netherlands (Email: P.Bresser{at}amc.uva.nl).

OBJECTIVES: In chronic thromboembolic pulmonary hypertension, objective data to assess the functional outcome after pulmonary endarterectomy are lacking. We studied the 6-minute walk distance in relation to the clinical and hemodynamic severity of disease, and assessed the effect of pulmonary endarterectomy on the 6-minute walk distance.

METHODS: A total of 50 consecutive patients with chronic thromboembolic pulmonary hypertension were studied. Subsequently, pulmonary endarterectomy was performed in 42 patients, 35 of whom underwent a 6-minute walk distance 1 year after surgery.

RESULTS: The mean ± standard error of the mean 6-minute walk distance was 391 ± 19 m. The 6-minute walk distance decreased in proportion to New York Heart Association functional class and correlated (all P < .0001) with mean pulmonary artery pressure (r = –0.62), cardiac output (r = 0.76), total pulmonary resistance (r = –0.75), mixed venous oxygen saturation (r = 0.77), and brain natriuretic peptide (r = –0.65). One year after pulmonary endarterectomy, the 6-minute walk distance increased from 417 ± 19 m to 517 ± 16 m (P < .0001). The change from baseline in 6-minute walk distance correlated with the changes after 1 year in New York Heart Association functional class (P < .01) and brain natriuretic peptide (r = 0.57, P < .002), and with the observed hemodynamic changes directly after pulmonary endarterectomy (change in mean pulmonary artery pressure: r = 0.52; change in cardiac output: r = 0.70; change in total pulmonary resistance r = 0.70; all P < .001). In patients with residual pulmonary hypertension after pulmonary endarterectomy, the 6-minute walk distance was significantly lower than in hemodynamically normalized patients. However, the absolute increase in the 6-minute walk distance was higher in patients with residual pulmonary hypertension (137 ± 26 m and 82 ± 20 m, respectively; P = .03).

CONCLUSIONS: The 6-minute walk distance was demonstrated to reflect the clinical and hemodynamic severity of disease in patients with chronic thromboembolic pulmonary hypertension. One year after pulmonary endarterectomy, the 6-minute walk distance had increased significantly, and the change in the 6-minute walk distance correlated with the observed clinical and hemodynamic improvement.



Abbreviations and Acronyms BNP = brain natriuretic peptide; CO = cardiac output; CTEPH = chronic thromboembolic pulmonary hypertension; iPAH = idiopathic pulmonary arterial hypertension; mPAP = mean pulmonary artery pressure; PEA = pulmonary endarterectomy; SvO2 = venous oxygen saturation; TPR = total pulmonary resistance; WSR = Wilcoxon signed-ranks





This article has been cited by other articles:


Home page
Ann. Thorac. Surg.Home page
M. N. van der Plas, H. J. Reesink, C. M. Roos, R. P. van Steenwijk, J. J. Kloek, and P. Bresser
Pulmonary Endarterectomy Improves Dyspnea by the Relief of Dead Space Ventilation.
Ann. Thorac. Surg., February 1, 2010; 89(2): 347 - 352.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
H. J. Reesink, S. Surie, J. J. Kloek, H. L. Tan, R. Tepaske, P. F. Fedullo, and P. Bresser
Bosentan as a bridge to pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension
J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 85 - 91.
[Abstract] [Full Text] [PDF]


Home page
ICVTSHome page
K. Ishida, M. Masuda, H. Tanaka, M. Imamaki, M. Katsumata, T. Maruyama, and M. Miyazaki
Mid-term results of surgery for chronic thromboembolic pulmonary hypertension
Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 626 - 629.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
X. Jais, A. M. D'Armini, P. Jansa, A. Torbicki, M. Delcroix, H. A. Ghofrani, M. M. Hoeper, I. M. Lang, E. Mayer, J. Pepke-Zaba, et al.
Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial.
J. Am. Coll. Cardiol., December 16, 2008; 52(25): 2127 - 2134.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
D. H. Freed, B. M. Thomson, S. S.L. Tsui, J. J. Dunning, K. K. Sheares, J. Pepke-Zaba, and D. P. Jenkins
Functional and haemodynamic outcome 1 year after pulmonary thromboendarterectomy
Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 525 - 530.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
A. G. Corsico, A. M. D'Armini, I. Cerveri, C. Klersy, E. Ansaldo, R. Niniano, E. Gatto, C. Monterosso, M. Morsolini, S. Nicolardi, et al.
Long-term Outcome after Pulmonary Endarterectomy
Am. J. Respir. Crit. Care Med., August 15, 2008; 178(4): 419 - 424.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
R. Condliffe, D. G. Kiely, J. S. R. Gibbs, P. A. Corris, A. J. Peacock, D. P. Jenkins, D. Hodgkins, K. Goldsmith, R. J. Hughes, K. Sheares, et al.
Improved Outcomes in Medically and Surgically Treated Chronic Thromboembolic Pulmonary Hypertension
Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1122 - 1127.
[Abstract] [Full Text] [PDF]


Home page
J Gerontol A Biol Sci Med SciHome page
Functional Outcomes for Clinical Trials in Frail Older Persons: Time To Be Moving: Working Group on Functional Outcome Measures for Clinical Trials
J Gerontol A Biol Sci Med Sci, February 1, 2008; 63(2): 160 - 164.
[Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The American Association for Thoracic Surgery.