Role of the Six-Minute Walk Test in Systemic Sclerosis: Five Years Evolution

Els Vandecasteele¹, Karin Melsens², Filip De Keyser³, Michel De Pauw⁴, Ellen Deschepper⁵, Saskia Decuman⁶, Yves Piette², Kristof Thevissen⁷, Guy Brusselle⁸ and Vanessa Smith³, ¹Dep of Cardiology, University Hospital Ghent, Ghent, Belgium, ²Ghent University Hospital, Department of Rheumatology, Ghent, Belgium, Ghent, Belgium, ³Ghent University, Department of Internal Medicine, Ghent, Belgium, Ghent, Belgium, ⁴Dep of cardiology, University Hospital Ghent, Ghent, Belgium, ⁵Biostatistics Unit, UGent, Ghent, Belgium, ⁶Department of Internal Medicine, Ghent University, Ghent, Belgium, ⁷University Hospital Ghent, Ghent, Belgium, ⁸Gent University, Gent, Belgium

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: exercise, interstitial lung disease and systemic sclerosis, Pulmonary Involvement

Session Information

Date: Sunday, November 5, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Title

Role of the Six-Minute Walk Test in Systemic Sclerosis: five years evolution.

Background/Purpose: Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the leading causes of death in Systemic Sclerosis (SSc) patients. Although the six-minute walk test (6MWT) is used for evaluating ILD and PAH in clinical practice, no data are available on the natural evolution of the six-minute walk distance (6MWD) in SSc patients without ILD and PAH.

Methods: Prospectively collected data of the first 6MWT (at baseline or at 6-month follow-up) and the 6MWTs at 18-, 30-, 42-, 54-, and 66-month visit of 165 consecutive SSc patients without ILD and PAH, included in the Ghent University Systemic Sclerosis Cohort between May 2006 and December 2016 were analysed.

Results: The mean 6MWD during the baseline 6MWT of 165 SSc patients without ILD and PAH (35% limited SSc, 56% limited cutaneous SSc, 9% diffuse cutaneous SSc) was 484.20+/-92.65m with no significant difference in the distance walked at different follow-up visits as compared to baseline. 96-100% of the SSc patients without ILD and PAH performed a 6MWT during the different follow-up visits.

Conclusion: In SSc without ILD and PAH, the 6MWT is feasible and the 6MWD is clinically stable over a 66 months period. A 6MWT performed at the time of SSc diagnosis may be used as a reference 6MWD for those SSc patients who develop ILD or PAH during follow-up.

Table 1. Baseline characteristics of 165 SSc without ILD and PAH.

Characteristic	N
Age (years) °	165	48.02+/-13.19
♀/♂ *	165	124/41 (75.2/24.8)
Raynaud *	165	162 (98.2)
Disease duration since first Raynaud (months)#	162	60 (20-176)
Disease duration since first non-Raynaud (months)#	137	26 (10-74)
LSSc/LcSSc/DcSSc *	165	58/92/15 (35.2/55.8/9.1)
mRSS #	165	3 (0-7)
DAS #	162	0.5 (0-1.5)
HAQ #	141	0.25 (0.00-0.63)
AntiScl70 AB *	165	16 (9.7)
ACA *	165	100 (60.6)
FVC (%pred) #	165	113 (99-126)
DLCO (%pred) #	165	77 (69-88)
Peak TVR (m/s) #	131	2.3 (2.1-2.4)
6MWD (m) °	165	484.20+/-92.65

°: mean+/-SD, *: n (%), #: median (IQR), mRSS: modified Rodnan Skin Score, DAS: disease activity score, HAQ: health assessment questionnaire, AntiScl70 AB: anti-topoisomerase I antibodies, ACA: anti-centromere antibodies, FVC: forced vital capacity, expressed as % of the predicted value, DLCO: diffusing capacity of the lung for carbon monoxide, expressed as % of the predicted value, Peak TVR: peak tricuspid valve regurgitation velocity, m/s: meter per second, 6MWD: six-minute walk distance.

Table 2. Evolution of the 6MWD from baseline to the different follow-up visits

	N 6MWT	N Tx visit	6MWD T0 (m) mean+/-SD	6MWD Tx(m) mean+/-SD	Pearson’s correlation coefficient	Mean Difference (95%CI) (m)	P
T0 vs T18	130	130	487.13+/-94.41	487.95+/-96.30	0.817	0.82 (-9.19; 10.83)	0.871
T0 vs T30	98	101	490.62+/-90.31	488.07+/-85.98	0.745	-2.55 (-15.20; 10.10)	0.690
T0 vs T42	77	80	481.56+/-95.56	466.52+/-105.49	0.694	-15.04 (-33.01; 2.93)	0.100
T0 vs T54	65	68	480.79+/-97.47	480.86+/-102.53	0.765	0.08 (-16.96; 17.12)	0.993
T0 vsT66	46	46	480.37+/-90.25	483.74+/-95.85	0.564	3.37 (-22.49; 29.23)	0.794

N 6MWT: number of patients performing a six-minute walk test, N Tx visit: number of patients having a follow-up visit at month x, 6MWD: six-minute walk distance, T0: baseline visit, Tx: x-month visit, m: meter, SD: standard deviation, CI: confidence interval

Disclosure: E. Vandecasteele, None; K. Melsens, None; F. De Keyser, None; M. De Pauw, None; E. Deschepper, None; S. Decuman, None; Y. Piette, None; K. Thevissen, None; G. Brusselle, None; V. Smith, Fund for Scientific Research Flanders, 2.

To cite this abstract in AMA style:

Vandecasteele E, Melsens K, De Keyser F, De Pauw M, Deschepper E, Decuman S, Piette Y, Thevissen K, Brusselle G, Smith V. Role of the Six-Minute Walk Test in Systemic Sclerosis: Five Years Evolution [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/role-of-the-six-minute-walk-test-in-systemic-sclerosis-five-years-evolution/. Accessed .

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