Jurnal Divisi Kardiologi

Six-Minute Walk Test as a Predictor for Outcome in Children

with Dilated Cardiomyopathy and Chronic Stable Heart Failure
Susanna L. den Boer, Danie ¨l H. K. Flips, Marijke H. van der Meulen, Ad P. C. M. Backx, Gideon J. du
Marchie Sarvaas, Arend D. J. Ten Harkel, Gabrie ¨lle G. van Iperen, Lukas A. J. Rammeloo, Ronald
B. Tanke, Willem A. Helbing, Tim Takken, Michiel Dalinghaus
Pediatr Cardiol (2017) 38:465–471 DOI 10.1007/s00246-016-1536-y

Pembimbing :
dr. Renny Suwarniaty, Sp.A (K)
dr. Dyahris Koentartiwi , Sp.A (K)

Oleh :
Ernita Selviana Tarigan
1
 Daftar Singkatan
• Cardiopulmonary exercise testing (CPET
• peak oxygen uptake (VO2
• with dilated cardiomyopathy (DCM)
• 6 min walk test (6MWT
• fractional shortening [FS]
• left ventricular (LV)
• LV end diastolic dimension [LVEDD]
• N-terminal pro-B-type natriuretic peptide (NT-
proBNP)
 Pendahuluan
Cardiopulmonary exercise testing (CPET) 
prognosis gagal jantung pada pasien dewasa
Transplantasi jantung  rekomendasi pada pasien
VO2 < 12-14 ml/kg/menit

Pasien anak dengan puncak VO2 <50% nilai prediksi

berdasarkan usia dan jenis kelamin  transplantasi
jantung.

Giardini et al  anak dengan DCM yang memiliki

puncak VO2 ≤ 62% beresiko 10 kali lipat terhadap
kematian dan membutuhkan transplantasi jantung
sesegera mungkin dibandingkan pasien dengan VO2
>62%.
• Keterbatasan CPET  waktu yang lama dan hanya pada
gagal jantung berat  alat yang rumit dan tenaga terlatih
• test yang lebih praktis 6 min walk test (6MWT)

• 6MWT pada Hipertensi paru  menilai tingkat keparahan

penyakit dalam memprediksi kematian dan transplantasi dan
menilai efek terapi . Dapat dilakukan mulai usia 6 tahun

• Tujuan Penelitian  menguji hipotesis bahwa 6MWT sebagai

prediktor kematian atau transplantasi jantung pada anak
dengan DCM
 Metode Penelitian

Jenis Penelitian Kriteria Inklusi Kriteria Eksklusi

• Penelitian • Usia ≥ 6 tahun • Kelainan

Prospektive • Kriteria DCM struktural pada
• Informed • Gangguan fungsi sistolik jantung
consent FS ≤ 25% and dilatasi LV • Penyakit
(LVEDD z-score > +2 ).
• Waktu neuromuskular
penelitian :
• 1 November 2010
s/d 1 July 2015
 Six-Minute Walk Test
all patients performed a 6 min walk test (6MWT) on an 8 m track in a straight corridor

The objective of the test was to walk as far as possible within 6 min. If
Patients were instructed to walk back and forth on a self-chosen walking
needed, patients were allowed to slow down the pace or to stop, but were
speed; running was not allowed.
encouraged to resume walking as soon as they were able to.

During the test, the number of laps was counted. The lap that was partially completed at the end of the test was measured and added to the
total distance.

A percentage of predicted (6MWD%) was calculated by dividing the

The distance walked during 6 min (6MWD) was compared with gender-
patients’ 6MWD by the patients’ predicted 6MWD, and multiplying this by
specific norm values as reported by Geiger et al.
100%.

Transcutaneous oxygen saturation and heart rate were recorded before and immediately after the test. Using a maximum heart rate of 200
beats per minute (bpm) for all ages, [13] the heart rate immediately after the test was transformed to a percentage of the maximum.
 N-terminal pro-B-type
patients’ demographics natriuretic peptide (NT- echocardiogram
proBNP)

The 6MWT results were

LVEDD and LV end-
not relayed to the
systolic dimension and
treating physicians and
subsequently, FS was
were only stored in the
calculated.
research database.
 Hasil Penelitian
64 pasien

56 pasien
(informed consent +)

7 pasien (out) 49 pasien (in)

6MWT