One-minute sit-to-stand test cut-offs for risk stratification based on six-minute walk test thresholds in pulmonary hypertension
Christina Kronberger, Roya Anahita Mousavi, Nikita Ermolaev, Robin Willixhofer, Nima Rassoulpour, Musa Bedirxan Kaya, Michael Poledniczek, Mahshid Eslami, Christoph Krall, Brigitte Litschauer, Mariusz Tadeusz Grzeda, Ian McKenna, Roza Badr EslamAbstract
Aims
We aimed to establish one-minute sit-to-stand test (1-min STST) cut-off values that align with the guideline-recommended six-minute walk test (6MWT) thresholds (165m and 440m) for one-year mortality risk stratification in pulmonary hypertension (PH) patients. Furthermore, we aimed to compare clinical characteristics and long-term mortality among patients stratified by these proposed 1-min STST cut-offs.
Methods
All patients performed the 1-min STST and 6MWT. Receiver operating characteristics analysis was performed to determine 1-min STST cut-offs corresponding to the 6MWT thresholds. Patients were stratified into three groups based on these cut-offs.
Results
Among 114 PH patients (mean age 66±14 years, 57% female), the mean number of 1-min STST repetitions was 17±6 and the mean 6MWT distance was 354±133m. The aligning 1-min STST cut-off for the <165m 6MWT threshold was 14 repetitions (sensitivity 69%, specificity 100%) with an AUC of 0.90 (95%-CI 0.84–0.97). For the >440m threshold, 20 repetitions (sensitivity 81%, specificity 84%) aligned with an AUC of 0.85 (95%-CI 0.75–0.94). Patients performing ≤14 repetitions had worse NT-proBNP levels (p<0.001), WHO-FC (p<0.001), mPAP (p=0.050), as well as health-related quality of life (HRQoL) (p<0.001) and a higher rate of mortality than those performing ≥20 repetitions (p=0.020).
Conclusion
The 1-min STST cut-offs aligning with the 6MWT thresholds of 165m and 440m are 14 and 20 repetitions, respectively. Patients performing ≤14 repetitions demonstrated worse clinical parameters and higher mortality rates, making the 1-min STST a potential risk stratification tool in PH patients.