6 minute walk test in assessing severity of interstitial lung disease: an observational study
6MWT in assessing severity of ILD
DOI:
https://doi.org/10.36141/svdld.v40i2.13991Keywords:
interstitial lung disease; pulmonary function test; quantitative CT; 6 minute walk testAbstract
BACKGROUND: 6 minute walk test (6MWT) is a potential tool in assessing severity of interstitial lung disease (ILD).
OBJECTIVES: To explore the relationship between 6MWT and traditional measures including pulmonary function and chest CT. To determine factors that may influence the 6 minute walk distance (6MWD).
METHODS: 73 patients with ILD were enrolled in the clinic of Peking University First Hospital. 6MWTs, pulmonary CTs and pulmonary function tests were performed and their correlations were analyzed. Multivariate regression analysis was used to determine factors that may impact 6MWD.
RESULTS: 30 (41.4%) of the 73 patients were female, the mean age was 66.1 ±9.6 years. 102 follow-up visits were completed. 6MWD and decrease of SpO2 were both correlated with FEV1, FVC, TLC and DLCO. The volume of normal lung area calculated by the quantitative CT software was positively correlated with 6MWD (r = 0.309, P < 0.01) and negatively correlated with decrease of SpO2 (r = -0.272, P < 0.01). Based on the backward multivariate model ( F = 10.537, P < 0.001, adjusted R2 = 0.509 ), 6MWD was predicted by age, height, body weight, baseline SpO2, increase of heart rate, FEV1, DLCO and FVC.
CONCLUSIONS: The results of 6MWTs were closely correlated with pulmonary function and quantitative CT in patients with ILD . However, aside from disease severity, 6MWD was influenced by personal characteristics and the degree of patient effort, which should be considered by clinicians interpreting 6WMT results.
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Travis WD, Costabel U, Hansell DM, et al; ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013;188(6):733-48.
Takizawa A, Kamita M, Kondoh Y, Bando M, Kuwana M, Inoue Y. Current monitoring and treatment of progressive fibrosing interstitial lung disease: a survey of physicians in Japan, the United States, and the European Union. Curr Med Res Opin 2021;37(2):327-339.
Chetta A, Aiello M, Foresi A, et al. Relationship between outcome measures of six-minute walk test and baseline lung function in patients with interstitial lung disease. Sarcoidosis Vasc Diffuse Lung Dis 2001;18(2):170-5.
Alhamad EH, Cal JG. Predictors of mortality in interstitial lung disease patients without pulmonary hypertension. Ann Thorac Med 2020;15(4):238-243.
Lancaster LH. Utility of the six-minute walk test in patients with idiopathic pulmonary fibrosis. Multidiscip Respir Med 2018;13:45.
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.
Chen A, Karwoski RA, Gierada DS, Bartholmai BJ, Koo CW. Quantitative CT Analysis of Diffuse Lung Disease. Radiographics 2020;40(1):28-43.
Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med 1995;152(3):1107-36.
Capaccione KM, Wang A, Lee SM, et al. Quantifying normal lung in pulmonary fibrosis: CT analysis and correlation with %DLCO. Clin Imaging 2021;77:287-290.
Kaya F, Özgül E, Balcı A. Quantitative and visual analysis of idiopathic pulmonary fibrosis with different methods: the relationship between clinical correlation and mortality risk model. Eur Rev Med Pharmacol Sci 2021;25(8):3254-3263.
Barros MC, Hochhegger B, Altmayer S, et al. The Normal Lung Index From Quantitative Computed Tomography for the Evaluation of Obstructive and Restrictive Lung Disease. J Thorac Imaging 2022;37(4):246-252.
Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 1998;158(5 Pt 1):1384-7.
Casanova C, Celli BR, Barria P, et al; Six Minute Walk Distance Project (ALAT). The 6-min walk distance in healthy subjects: reference standards from seven countries. Eur Respir J 2011;37(1):150-6.
Halliday SJ, Wang L, Yu C, et al. Six-minute walk distance in healthy young adults. Respir Med 2020;165:105933.
Weir NA, Brown AW, Shlobin OA, et al. The influence of alternative instruction on 6-min walk test distance. Chest 2013;144(6):1900-1905.
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