• Clin Exp Rheumatol · Mar 2013

    Six-minute walk test reflects neurohormonal activation and right ventricular function in systemic sclerosis patients.

    • Katarzyna Irzyk, Piotr Bienias, Maciej Kostrubiec, Zuzanna Rymarczyk, Zbigniew Bartoszewicz, Maria Siwicka, Anna Stelmaszczyk-Emmel, Elzbieta Górska, Urszula Demkow, Piotr Pruszczyk, and Michal Ciurzyński.
    • Medical University of Warsaw, Department of Internal Medicine and Cardiology, Warsaw, Poland. kirzyk35575@gmail.com
    • Clin Exp Rheumatol. 2013 Mar 1; 31 (2 Suppl 76): 18-23.

    ObjectivesHeart and pulmonary involvement is a leading cause of systemic sclerosis (SSc)-related deaths. The six-minute walk test (6MWT) is a simple and reproducible test commonly used to evaluate exercise capacity. We tried to assess a potential relationship between exercise capacity assessed by 6MWT, echocardiographic parameters of right ventricular function and serum levels of endothelin-1 and NTproBNP.MethodsWe prospectively studied 111 consecutive patients (101F, 10M, age 54.2±13.8 years) with diagnosed SSc (mean disease duration 9±12.4 years) and a group of 21 age-matched subjects (18F, 3M, age 49.3±10.5 years). In addition to routine evaluation, 6MWT and transthoracic echocardiography (Phillips iE 33) were performed. We also measured serum endothelin-1 (Human Endothelin-1 immunoassay R & D Systems) and NT-proBNP levels (Elecsys pro-BNP immunoassay; Roche Diagnostics).ResultsThe mean 6MWT distance was significantly shorter in the SSc group than in the controls (562.8±60.3 vs. 514.7±102.5 m, p=0.03). In the SSc group 6MWT distance correlated with ET-1 (r=-0.5, p<0.0001), NTproBNP (r=-0.4, p=0.0008) levels, and echocardiographic indices AcT (r=0.4, p=0.0002) and TRPG (r=-0.4, p=0.0011). Moreover, in patients with 6MWT distance <450 m NTproBNP and endotothelin-1 levels were significantly higher than in patients with distance >450 m (311.2, 31.1-17237 vs. 105.3, 5-17670 pg/ml, p=0.0138 and 2.9±2.2 vs. 1.4±0.7 pg/ml, p=0.0032).ConclusionsDecreased exercise capacity significantly correlates with biochemical and echocardiographic parameters of right ventricular dysfunction and neurohormonal activation providing a potential link for neuroendocrine derangement in patients with SSc.

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