Validity of estimated aortic pulse wave velocity measured during the 6-minute walk test to predict anaerobic fitness before major non-cardiac surgery

• Published in: Revista española de anestesiología y reanimación (English ed.)
• Main Authors: Ripollés-Melchor, J, Monge García, M I, Ruiz-Escobar, A, Sáez-Ruiz, E, Algar-Yañez, B, Abad-Motos, A, Abad-Gurumeta, A
• Format: Journal Article
• Language: English
• Published: Spain 06.09.2024
• Subjects: Arterial stiffness; Pulse wave velocity; Prueba de ejercicio; Rigidez arterial; Exercise test; Preoperative care; Cuidados preoperatorios; Velocidad de onda de pulso
• ISSN: 2341-1929

This study aimed to assess the efficacy of estimated preoperative aortic pulse wave velocity (AoPWV) to discriminate between low and high 6 min walk test (6MWT) distance in patients awaiting major non-cardiac surgery. Prospective observational study in 133 patients undergoing non cardiac surgery. AoPWV and the distance walked during a 6MWT were assessed. Receiver operating characteristic (ROC) curve analysis was used to determine two different AoPWV cut-points for predicting a distance of 427 metres in the 6MWT. We also calculated lower and upper AoPWV cut-points (probability ≥ 0.75) for predicting a distance of < 427 metres, ≥ 427 metres, and also 563 metres in the 6MWT. The ROC curve analysis for the < 427 metre distance revealed an area under the curve (AUC) of 0.68 (95% confidence interval 0.56-0.79) and an AUC of 0.72 (95% confidence interval 0.61-0.83) for > 563 metres. Patients with AoPWV > 10.97 m/s should be considered high risk, while those with < 9.42 m/s can be considered low risk. AoPWV is a simple, non-invasive, useful clinical tool for identifying and stratifying patients awaiting major non-cardiac surgery. In situations of clinical uncertainty, additional measures should be taken to assess the risk.