Role of pulmonary hemodynamics in determining 6-minute walk test result in atrial septal defect: an observational study

Abstract
Background: The presence of altered pulmonary hemodynamics in adult patients with atrial septal defect (ASD) is
common. However, there are no observational studies which evaluate the impact of altered pulmonary hemodynamics on
the 6-min walk test (6MWT) result. This study aimed to investigate the role of pulmonary hemodynamics in determining
6MWT result of patients with ASD.
Method: Forty-six consecutive adult patients with ASD were included in this study. Right heart catheterization
was performed to obtain the pulmonary hemodynamics profile. Meanwhile, 6MWT was presented as high or
low with cut-off point 350 m. Receiver operating characteristic (ROC) was used for analytical methods.
Result: Abnormal functional capacity was indicated by ROC result of mPAP cut-off value of > 24 mmHg (p = 0.0243;
AUC = 0.681). The value of PVR > 3.42 woods unit (WU) showed high specificity in determining abnormal functional
capacity (p = 0.0069; AUC = 0.713). Flow ratio with cut-off point ≤4.89 had the highest sensitivity (100%) (p = 0.8300;
AUC = 0.520).
Conclusion: Pulmonary hemodynamics can serve as an indicator of 6MWT result in adult ASD patients with values of
mPAP> 24 mmHg and PVR > 3.42 WU.

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