Role of pulmonary hemodynamics in determining 6-minute walk test result in atrial septal defect: an observational study

J Cardiothorac Surg. 2018 May 22;13(1):51. doi: 10.1186/s13019-018-0725-6.

Abstract

Background: The presence of altered pulmonary hemodynamics in adult patients with atrial septal defect (ASD) is common. However, there are no observational studies which evaluate the impact of altered pulmonary hemodynamics on the 6-min walk test (6MWT) result. This study aimed to investigate the role of pulmonary hemodynamics in determining 6MWT result of patients with ASD.

Method: Forty-six consecutive adult patients with ASD were included in this study. Right heart catheterization was performed to obtain the pulmonary hemodynamics profile. Meanwhile, 6MWT was presented as high or low with cut-off point 350 m. Receiver operating characteristic (ROC) was used for analytical methods.

Result: Abnormal functional capacity was indicated by ROC result of mPAP cut-off value of > 24 mmHg (p = 0.0243; AUC = 0.681). The value of PVR > 3.42 woods unit (WU) showed high specificity in determining abnormal functional capacity (p = 0.0069; AUC = 0.713). Flow ratio with cut-off point ≤4.89 had the highest sensitivity (100%) (p = 0.8300; AUC = 0.520).

Conclusion: Pulmonary hemodynamics can serve as an indicator of 6MWT result in adult ASD patients with values of mPAP> 24 mmHg and PVR > 3.42 WU.

Keywords: Atrial septal defect; Cardiac catheterization; Hemodynamic; Pulmonary hypertension.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Cardiac Catheterization
  • Exercise Tolerance*
  • Female
  • Heart Septal Defects, Atrial / physiopathology*
  • Hemodynamics*
  • Humans
  • Hypertension, Pulmonary / physiopathology*
  • Male
  • Middle Aged
  • Pulmonary Circulation*
  • ROC Curve
  • Walk Test
  • Young Adult