Copyright © Italian Federation of Cardiology. Unauthorized reproduction of this article is prohibited. Predictors of exercise capacity in patients with chronic heart failure Irfan Daullxhiu a , Edmond Haliti a , Afrim Poniku a , Artan Ahmeti a , Violeta Hyseni a , Rozafa Olloni a , Zana Vela a , Shpend Elezi a , Gani Bajraktari a and Teuta Daullxhiu b Background Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. The six-minute walking test (6-MWT) may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to cardiopulmonary exercise testing (CPET). The CPET and 6-MWT are the most broadly used for assessing functional limitation in patients with heart failure. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population. Methods This study included 132 consecutive patients (61 W 10 years, 45% women) with stable heart failure. All patients underwent 6-MWT and Doppler echocardiographic examination on the same day. Clinical, biochemical and echocardiographic predictors were analyzed to assess predictors of exercise capacity. Patients were divided into two groups based on the 6-MWT distance. The first group comprised patients with limited exercise performance ( < — 300 m), and the second group, patients with good exercise performance (>300 m). Results In univariate analysis, patients’ age [0.931 (0.895– 0.968), P < 0.001], arterial hypertension [0.481 (0.239– 0.967), P U 0.040], blood urea level [0.860 (0.759–0.975), P U 0.019], New York Heart Association (NYHA) class [0.441 (0.245–0.795), P U 0.006], early diastolic E wave [1.014 (1.000–1.029), P U 0.047], total isovolumic time (t-IVT) [0.868 (0.796–0.947), P U 0.001], Tei index [0.112 (0.028– 0.450), P U 0.002], and E 0 of left-ventricular (LV) lateral wall [1.188 (1.099–1.400), P U 0.039] independently predicted poor 6-MWT performance (<300 m). In multivariate analysis, only patients’ age [0.948 (0.902–0.996), P U 0.034], arterial hypertension [0.351 (0.133–0.922), P U 0.034], and t-IVT [0.828 (0.725–0.946), P U 0.005] independently predicted poor 6-MWT performance (<300 m). Conclusion In chronic stable heart failure patients, in addition to age, systemic hypertension as well as LV asynchrony, as reflected by prolonged t-IVT, are independent predictors of poor exercise capacity. J Cardiovasc Med 12:223–225 Q 2011 Italian Federation of Cardiology. Journal of Cardiovascular Medicine 2011, 12:223–225 Keywords: chronic heart failure, echocardiography, six-minute walk test a Cardiology Service, University Clinical Centre of Kosovo, Prishtina and b Private Cardiology Clinic ‘Zemra’, Prizren, Kosovo Correspondence to Irfan Daullxhiu, Cardiology Service, University Clinical Centre of Kosovo, Prishtina, Kosovo Tel: +381 38 500 600 x3054; fax: +381 38 543 466; e-mail: irfan_daullxhiu@yahoo.com Received 20 December 2010 Accepted 20 December 2010 Introduction Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regi- men [1]. The six-minute walking test and echocardio- graphy are both useful techniques for the assessment of heart failure patients. The main indication for using the six-minute walking test (6-MWT) is for measuring the response to medical inter- ventions in patients with moderate to severe heart or lung disease [2]. Cardiopulmonary exercise testing (CPET) and 6-MWT have also been used as predictors of the functional status of patients with heart failure [3], as well as morbidity and mortality. As most activities of daily living are performed at submaximal levels of exertion, the 6-MWTis useful for assessing the functional exercise level for daily physical activities. The 6-MWT may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to CPET [3]. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population [1]. Methods The study included 132 consecutive patients (61  10 years, 45% women) with stable heart failure. All Short communication 1558-2027 ß 2011 Italian Federation of Cardiology DOI:10.2459/JCM.0b013e328343e950