• Cristiane Pulz, Rosiane V Diniz, Alexandre N F Alves, Antônio S Tebexreni, Antônio C Carvalho, Angelo A V de Paola, and Dirceu R Almeida.
• Department of Medicine, Federal University of São Paulo, São Paulo, Brazil. cris1801@yahoo.com
• Can J Cardiol. 2008 Feb 1;24(2):131-5.

BackgroundThe incremental shuttle test presents some theoretical advantages over the six-minute walk test in chronic heart failure (CHF), including better standardization and less dependency on collaboration.ObjectivesThe present study evaluated test-retest repeatability, test accuracy in predicting a peak oxygen consumption (VO(2)) of 14 mL/kg/min or less, as well as the prognostic value of both walking tests in stable CHF patients.MethodsSixty-three patients (44 men; New York Heart Association functional class II to IV) underwent an incremental treadmill exercise test and, on another day, the walk test in duplicate.ResultsPatients showed well-preserved functional capacity according to the distance walked in both tests (six-minute walk test 491+/-94 m versus incremental shuttle walk test 422+/-119 m; P<0.001). Interestingly, the six-minute and incremental shuttle walk test differences in distance walked were higher in more disabled patients. The mean bias +/-95% CI of the within-test differences were similar (7+/-40 m and 8+/-45 m, respectively). Peak VO(2), but not distance walked in either test, was associated with survival (P<0.05).ConclusionsThe incremental shuttle walk test showed similar repeatability and accuracy in estimating peak VO(2) compared with the six-minute walk test in CHF patients. Direct measurement of peak VO(2), however, remains superior to either walking test in predicting survival--at least in patients with well-preserved functional capacity.

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