TY - JOUR
T1 - The six-minute walk test in sarcoidosis associated pulmonary hypertension
T2 - Results from an international registry
AU - Gupta, Rohit
AU - Baughman, Robert P.
AU - Nathan, Steven D.
AU - Wells, Athol U.
AU - Kouranos, Vasilis
AU - Alhamad, Esam H.
AU - Culver, Daniel A.
AU - Barney, Joseph
AU - Carmona, Eva M.
AU - Cordova, Francis C.
AU - Huitema, Marloes
AU - Scholand, Mary Beth
AU - Wijsenbeek, Marlies
AU - Ganesh, Sivagini
AU - Birring, Surinder S.
AU - Price, Laura C.
AU - Wort, Stephen John
AU - Shlobin, Oksana A.
N1 - Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SJW has received honoraria for lectures and advisory boards from Janssen (previously known as Actelion), Bayer, MSD and GSK. He has received travel grants from Janssen and GSK. He has received research grants from Bayer and Janssen. RPB has grant support from Gilead, Bayer, Actelion, Genentech, aTyr, Novartis, and Bellephron for studies in sarcoidosis. OAS consults for and is a speaker for Bayer, United Therapeutics, and Janssen & Janssen. LCP declares personal fees from Janssen Pharmaceuticals, outside the submitted work.
Funding Information:
The registry is supported by an unrestricted grant from Gilead Pharmaceuticals.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/5
Y1 - 2022/5
N2 - Introduction: Sarcoidosis associated pulmonary hypertension (SAPH) is a leading contributor to sarcoidosis-related mortality. The 6-min walk test (6MWT) is widely used in assessment of cardiorespiratory conditions. A reduced 6-min walk distance (6MWD) has been associated with increased mortality in SAPH. We examined patients from the Registry of Sarcoidosis Associated Pulmonary Hypertension (ReSAPH) who had performed 6MWT at enrollment to identify variables that affect 6MWD, and the prognostic value of 6MWT variables regarding death or lung transplantation. Material and methods: ReSAPH patients with available 6MWT were included. Variables analyzed using pre-defined cutoffs included 6MWD, initial and end of test Borg dyspnea score, oxygen saturation, and heart rate at beginning, end, and after 1-min recovery, absolute change in oxygen saturation, modified distance-saturation product (mDSP), and the heart rate recovery at 1-min (HRR). Findings: 174 patients met inclusion criteria; 48 patients died and 8 underwent lung transplantation. Patients with 6MWD<300 m had a higher chance of dying or undergoing transplantation compared to those with 6MWD>300 m (p = 0.012). No associations with outcome were observed with mDSP cutoff 200 m%, desaturation≥5% and oxygen saturation<88% at end of 6MWT, or multiple HRR cutoffs (13,14,16). 6MWD correlated with initial Borg score, (p = 0.001), DLCO% (p = 0.0001) and sPAP (p = 0.031) on multivariate analysis. These variables were significant for both pre- and post-capillary PH subgroups. 6MWD also correlated with fatigue assessment scale (FAS) (p = 0.015). Conclusion: Of the parameters evaluated, 6MWD had the greatest prognostic value in SAPH which correlated with other physiologic and hemodynamic variables. 6MWT captures the multidimensional effects of sarcoidosis.
AB - Introduction: Sarcoidosis associated pulmonary hypertension (SAPH) is a leading contributor to sarcoidosis-related mortality. The 6-min walk test (6MWT) is widely used in assessment of cardiorespiratory conditions. A reduced 6-min walk distance (6MWD) has been associated with increased mortality in SAPH. We examined patients from the Registry of Sarcoidosis Associated Pulmonary Hypertension (ReSAPH) who had performed 6MWT at enrollment to identify variables that affect 6MWD, and the prognostic value of 6MWT variables regarding death or lung transplantation. Material and methods: ReSAPH patients with available 6MWT were included. Variables analyzed using pre-defined cutoffs included 6MWD, initial and end of test Borg dyspnea score, oxygen saturation, and heart rate at beginning, end, and after 1-min recovery, absolute change in oxygen saturation, modified distance-saturation product (mDSP), and the heart rate recovery at 1-min (HRR). Findings: 174 patients met inclusion criteria; 48 patients died and 8 underwent lung transplantation. Patients with 6MWD<300 m had a higher chance of dying or undergoing transplantation compared to those with 6MWD>300 m (p = 0.012). No associations with outcome were observed with mDSP cutoff 200 m%, desaturation≥5% and oxygen saturation<88% at end of 6MWT, or multiple HRR cutoffs (13,14,16). 6MWD correlated with initial Borg score, (p = 0.001), DLCO% (p = 0.0001) and sPAP (p = 0.031) on multivariate analysis. These variables were significant for both pre- and post-capillary PH subgroups. 6MWD also correlated with fatigue assessment scale (FAS) (p = 0.015). Conclusion: Of the parameters evaluated, 6MWD had the greatest prognostic value in SAPH which correlated with other physiologic and hemodynamic variables. 6MWT captures the multidimensional effects of sarcoidosis.
KW - Registry of sarcoidosis associated pulmonary hypertension
KW - Sarcoidosis
KW - Sarcoidosis associated pulmonary hypertension
KW - Six-minute walk distance
KW - Six-minute walk test
UR - http://www.scopus.com/inward/record.url?scp=85127572895&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127572895&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2022.106801
DO - 10.1016/j.rmed.2022.106801
M3 - Article
C2 - 35316723
AN - SCOPUS:85127572895
SN - 0954-6111
VL - 196
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
M1 - 106801
ER -