6MWD Risk Category Calculator
- 6-Minute Walk Distance (6MWD) Risk Category: Explanation and Clinical Context
The 6-Minute Walk Distance (6MWD) is a standardized submaximal exercise test used to evaluate functional capacity in patients with pulmonary arterial hypertension (PAH). It measures the distance a patient can walk on a flat, hard surface in six minutes. Within the ESC/ERS 2022 risk assessment framework, 6MWD is a key parameter for estimating 1-year mortality risk.
Patients are classified into risk categories based on distance thresholds:
- Low Risk: >440 m, associated with good functional status and estimated 1-year mortality <5%.
- Intermediate Risk: 165–440 m, indicating moderate exercise limitation and 1-year mortality of 5–20%.
- High Risk: <165 m, reflecting severe limitation and estimated 1-year mortality >20%.
The 6MWD serves as a dynamic marker of disease progression and treatment response. Changes of approximately 30–45 m represent the minimal clinically important difference (MCID) and are considered meaningful in clinical practice.
It should be interpreted alongside other prognostic indicators such as WHO Functional Class, BNP/NT-proBNP levels, and hemodynamic parameters to improve accuracy. Regular reassessment every 3–6 months is recommended to monitor therapy effectiveness and patient prognosis.
Reference:
Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2022;61(1):2200879. doi:10.1183/13993003.00879-2022
Grünig E, et al. Prognostic value of 6-minute walk distance and other exercise variables in PAH: analysis from the COMPERA registry. Eur Respir J. 2013;42(3):585–593.
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med. 2002;166(1):111–117.
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