Correlation between 6-minute walk test distance and New York Heart Association class in stable heart failure patients with ejection fraction ≤ 35%

Year 2026, Volume: 6 Issue: 1, 17 - 24, 12.03.2026

Eren Gürsoy , Tamer Sayın , Çetin Erol

https://doi.org/10.66235/kumj.1901676

https://izlik.org/JA33EL98AN

Abstract

Aims: The 6-Minute Walk Test is a submaximal exercise test used to assess functional capacity. The New York Heart Association Functional Classification is a key tool for evaluating heart failure severity but relies on subjective assessments, such as patient history and physical examination. The 6-minute Walk Test may provide a more objective measure to support the New York Heart Association Classification. This study investigates the correlation between 6-Minute Walk Test distance and New York Heart Association Class in stable heart failure patients with an ejection fraction ≤ 35%.

Methods: Our study included stable heart failure patients with an ejection fraction of ≤ 35% who were admitted to the Cardiology Outpatient Clinic at Ankara University Faculty of Medicine. We investigated the correlation between the 6-Minute Walk Test distance and the New York Heart Association Functional Class in this patient population. Additionally, we compared the demographic and clinical characteristics of the groups.

Results: A total of 47 patients (mean age: 59.8 ± 12.4 years, 25.5% female) were included in the study. Among them, 8.5% were classified as Functional Class I, 34.0% as Class II, and 57.4% as Class III according to the New York Heart Association Classification. A moderate negative correlation was observed between the 6-Minute Walk Test distance and New York Heart Association Functional Class (r = -0.67). Additionally, a weak negative correlation was found between the 6-Minute Walk Test distance and age (r = -0.37). Patients receiving mineralocorticoid receptor antagonists walked longer distances during the 6-Minute Walk Test. No adverse events were observed during the test.

Conclusion: The 6-Minute Walk Test is a semi-objective, simple, cost-effective, practical and reliable diagnostic tool. It serves as a valuable complementary method that supports traditional subjective assessments, such as anamnesis and physical examination, in determining the New York Heart Association Functional Class.

Keywords

6-Minute Walk Test , severely reduced ejection fraction , NYHA functional classification , stable heart failure

Ethical Statement

Ethical approval for the study was obtained from the Non-Interventional Research Ethics Committee of Ankara University Date: 24.07.2014.

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