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Open Access Highly Accessed Research article

Outcome measures of the 6 minute walk test: relationships with physiologic and computed tomography findings in patients with sarcoidosis

Esam H Alhamad1*, Shaffi Ahmad Shaik2, Majdy M Idrees3, Mohammed O Alanezi4 and Arthur C Isnani5

Author Affiliations

1 Pulmonary Davison, Department of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

2 Department of Family & Community Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

3 Pulmonary Medicine, Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia

4 Pulmonary Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia

5 College of Medicine and Research Center, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

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BMC Pulmonary Medicine 2010, 10:42  doi:10.1186/1471-2466-10-42

Published: 9 August 2010

Abstract

Background

We assessed the relationship between physiologic parameters, computed tomography patterns, 6 minute walk distance (6MWD) and the distance-saturation product [DSP; defined as the product of the 6MWD and the lowest oxygen saturation during the 6 minute walk test (6MWT)]. In addition, we investigated factors affecting 6MWD in patients with pulmonary sarcoidosis.

Methods

We performed a retrospective study of patient demographics, treatment, pulmonary function, 6MWT, echocardiography and computed tomography results.

Results

Fifty nine patients were included in this study. Their mean+standard deviation age was 47.5 years + 12.5 years, and 42 (71.2%) were female. Mean pulmonary function parameters for forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and total lung capacity (TLC) results, as percentages of predicted values, were 77.6 ± 22.2, 77.1 ± 22.8 and 78.7 ± 16.1, respectively. Comparison of the DSP with distance walked revealed a significant correlation with factors underlying reduced 6MWD, including gender, pulmonary function indices, partial pressure of oxygen (PaO2), and Borg dyspnea score. Other factors were significantly associated with DSP but not distance; these included lung fibrosis (p = 0.02), pulmonary hypertension (p = 0.01) and systemic therapy (p = 0.04). Backward elimination stepwise multiple regression analysis revealed that gender, and FEV1 were independent predictors of 6MWD, but FEV1 was more strongly related when DSP applied [DSP, R2 = 0.53, p = 0.02; distance, R2 = 0.45, p < 0.0001].

Conclusion

Our findings reveal that, compared to 6MWD alone, the DSP is correlated with a greater number of factors associated with reduced 6MWT performance. Therefore, the DSP may be a useful indicator of functional status in patients with sarcoidosis. Additional large-scale studies are warranted to validate our findings.