Left-ventricular function and physical performance on the 6-min walk test in older patients after inpatient cardiac rehabilitation

Objective: The 6-min walk test (6mWT) is widely used to assess physical performance in cardiac rehabilitation settings, Factors affecting the walked distance before starting physical training have been described, whereas information on factors affecting the increase of the walked distance after physical training is still scant. The aim of this study was to verify, in a large sample of elderly patients soon after cardiac surgery, the role of left-ventricular function (LVF) in increases in distances walked after an intensive rehabilitation program. Design: We enrolled 459 patients (300 males and 159 females, mean [+/- SDI] age 70 +/- 11 yrs). According to the echographic ejection fraction, patients were classed into two categories, LVF >= 40% and LVF < 40%. All patients performed the 6mWT at the beginning and end of the rehabilitation program. Results: Longer walked distances before and after the rehabilitation program were significantly associated with preserved or moderately depressed LVF, whereas greater relative increases of the distance walked after the rehabilitation program were significantly associated with poor LVF (P < 0.001 for all). Conclusions: Among elderly patients admitted as inpatients to an intensive rehabilitation program soon after cardiac surgery, those with poor LVF are most likely to respond more favorably to physical training. Therefore, instead of considering poor LVF a risk for starting physical training in these patients, it should be considered a strong indication, to avoid further physical deconditioning and disability.