Incremental Shuttle Walking Test Distance and Autonomic Dysfunction Predict Survival in Pulmonary Arterial Hypertension

Background To ensure effective monitoring of pulmonary arterial hypertension (PAH), a simple, reliable assessment of exercise capacity, applicable over a range of disease severity is needed. The study aim was to assess the ability of the incremental shuttle walking test (ISWT) to correlate with disease severity, measure sensitivity to change and predict survival in PAH. Methods 418 treatment-naïve patients with PAH, with baseline ISWT within 3 months of cardiac catheterization, were enrolled. The clinical validity and prognostic value of the ISWT distance was assessed at baseline and 1 year. Results ISWT distance was found to correlate at baseline with World Health Organisation functional class, Borg score and haemodynamics without a ceiling-effect (all p