{"doi":"10.1038/s41598-024-53817-3","title":"Incremental prognostic value of functional impairment assessed by 6-min walking test for the prediction of mortality in heart failure","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Natriuretic peptides (NP) are recognized as the most powerful predictors of adverse outcomes in heart failure (HF). We hypothesized that a measure of functional limitation, as assessed by 6-min walking test (6MWT), would improve the accuracy of a prognostic model incorporating a NP. This was a multicenter observational retrospective study. We studied the prognostic value of severe functional impairment (SFI), defined as the inability to perform a 6MWT or a distance walked during a 6MWT &lt; 300 m, in 1696 patients with HF admitted to cardiac rehabilitation. The primary outcome was 1-year all-cause mortality. After adjusting for the baseline multivariable risk model—including age, sex, systolic blood pressure, anemia, renal dysfunction, sodium level, and NT-proBNP—or for the MAGGIC score, SFI had an odds ratio of 2.58 (95% CI 1.72–3.88; p &lt; 0.001) and 3.12 (95% CI 2.16–4.52; p &lt; 0.001), respectively. Adding SFI to the baseline risk model or the MAGGIC score yielded a significant improvement in discrimination and risk classification. Our data suggest that a simple, 6MWT-derived measure of SFI is a strong predictor of death and provide incremental prognostic information over well-established risk markers in HF, including NP, and the MAGGIC score.</jats:p>","journal":"Scientific Reports","year":2024,"id":621416,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1604670,"name":"Pietro Guida","orcid":null,"position":1,"is_corresponding":false},{"id":1604671,"name":"Maria Teresa La Rovere","orcid":null,"position":2,"is_corresponding":false},{"id":1604672,"name":"Laura Adelaide Dalla Vecchia","orcid":null,"position":3,"is_corresponding":false},{"id":1604673,"name":"Giovanni Forni","orcid":null,"position":4,"is_corresponding":false},{"id":1604674,"name":"Rosa Raimondo","orcid":null,"position":5,"is_corresponding":false},{"id":1604675,"name":"Simonetta Scalvini","orcid":null,"position":6,"is_corresponding":false},{"id":1604676,"name":"Andrea Passantino","orcid":null,"position":7,"is_corresponding":false},{"id":1604669,"name":"Domenico Scrutinio","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Incremental prognostic value of functional impairment assessed by 6-min walking test for the prediction of mortality in heart failure","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Natriuretic peptides (NP) are recognized as the most powerful predictors of adverse outcomes in heart failure (HF). We hypothesized that a measure of functional limitation, as assessed by 6-min walking test (6MWT), would improve the accuracy of a prognostic model incorporating a NP. This was a multicenter observational retrospective study. We studied the prognostic value of severe functional impairment (SFI), defined as the inability to perform a 6MWT or a distance walked during a 6MWT &lt; 300 m, in 1696 patients with HF admitted to cardiac rehabilitation. The primary outcome was 1-year all-cause mortality. After adjusting for the baseline multivariable risk model—including age, sex, systolic blood pressure, anemia, renal dysfunction, sodium level, and NT-proBNP—or for the MAGGIC score, SFI had an odds ratio of 2.58 (95% CI 1.72–3.88; p &lt; 0.001) and 3.12 (95% CI 2.16–4.52; p &lt; 0.001), respectively. Adding SFI to the baseline risk model or the MAGGIC score yielded a significant improvement in discrimination and risk classification. Our data suggest that a simple, 6MWT-derived measure of SFI is a strong predictor of death and provide incremental prognostic information over well-established risk markers in HF, including NP, and the MAGGIC score.</jats:p>","is_dataset_classified":null,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38321196","pmcid":"PMC10847418","openalex_id":"https://openalex.org/W4391610035","authors":[],"funders":[],"total_grants":0,"fwci":2.9638,"citation_percentile":0.91900344,"influential_citations":0,"citation_trend":[{"year":2024,"count":3},{"year":2025,"count":5},{"year":2026,"count":2}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.nature.com/articles/s41598-024-53817-3.pdf","host_type":"journal"},{"url":"https://www.nature.com/articles/s41598-024-53817-3.pdf","host_type":"publisher"},{"url":"https://www.nature.com/articles/s41598-024-53817-3","host_type":"publisher"},{"url":"https://doi.org/10.1038/s41598-024-53817-3","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38321196","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10847418","host_type":"repository"},{"url":"https://doaj.org/article/ae80b2ed5fe3422d8c6d9cd7ce3214cb","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10847418/pdf/41598_2024_Article_53817.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC10847418","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC10847418?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Heart Failure Treatment and Management","Cardiovascular Function and Risk Factors","Cardiovascular and exercise physiology","Humans","Prognosis","Retrospective Studies","Heart Failure","Walk Test","Walking","Natriuretic Peptide, Brain","Peptide Fragments","Biomarkers","Predictive Value of Tests"],"mesh_terms":["Walk Test","Heart Failure","Humans","Peptide Fragments","Predictive Value of Tests","Prognosis","Retrospective Studies","Biomarkers","Walking","Natriuretic Peptide, Brain"],"keywords":["Medicine","Heart failure","Internal medicine","Cardiology","Odds ratio","Observational study","Confidence interval","Retrospective cohort study","Anemia","Blood pressure"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T14:28:25.212870Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}