Published online Nov 27, 2021. doi: 10.4254/wjh.v13.i11.1791
Peer-review started: February 9, 2021
First decision: May 13, 2021
Revised: May 18, 2021
Accepted: October 12, 2021
Article in press: October 12, 2021
Published online: November 27, 2021
Patients with cirrhosis are at risk of cirrhotic cardiomyopathy, with resulting cardiac dysfunction and exercise limitations. Six minute walking test (6MWT) assesses functional status and predicts morbidity and mortality in cardiopulmonary diseases.
To determine if it associates with mortality by analyzing 6MWT performance in patients with liver cirrhosis.
A cohort of 106 cirrhotic patients was evaluated in the outpatient setting with echocardiogram and 6MWT and follow up for one year to document hepatic decompensation and mortality. The distance in meters was recorded at the end of 6 min (6MWD).
This cohort had a mean age of 51 years and 56% male; patients were staged as Child A in 21.7%, B 66% and C 12.3%. Walk distance inversely correlated with Child scores, and was significantly reduced as Child stages progresses. Patients who died (10.4%) showed shorter mean 6MWD (P = 0.006). Low 6MWD was an independent predictor of mortality (P = 0.01).
6MWT is a noninvasive inexpensive test whose result is related to Child scores and mortality. It is useful to identify patients with liver cirrhosis at high risk of mortality for closer monitoring and potential early intervention.
Core Tip: Our study proposes that six-minute walking test, a simple exercise test, can be applicable in the evaluation of cirrhotic patients. This is a well-none routine assessment in patients with cardiopulmonary diseases, where it is used to predict mortality in this population. Its use in liver cirrhosis is limited. Patients with chronic hepatic insufficient are at risk of progressively muscle loss, frailty, and exercise limitation, all factors directly associated with poor survival. We propose by using six-minute walk test a practical and simple manner of assess this risks and provide a better understanding of how exercise limitation can directly affect survival.