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We hypothesized that a measure of functional limitation, as assessed by 6-min walking test (6MWT), would improve the accuracy of a prognostic model incorporating a NP. This was a multicenter observational retrospective study. We studied the prognostic value of severe functional impairment (SFI), defined as the inability to perform a 6MWT or a distance walked during a 6MWT\u2009&lt;\u2009300 m, in 1696 patients with HF admitted to cardiac rehabilitation. The primary outcome was 1-year all-cause mortality. After adjusting for the baseline multivariable risk model\u2014including age, sex, systolic blood pressure, anemia, renal dysfunction, sodium level, and NT-proBNP\u2014or for the MAGGIC score, SFI had an odds ratio of 2.58 (95% CI 1.72\u20133.88; p\u2009&lt;\u20090.001) and 3.12 (95% CI 2.16\u20134.52; p\u2009&lt;\u20090.001), respectively. Adding SFI to the baseline risk model or the MAGGIC score yielded a significant improvement in discrimination and risk classification. Our data suggest that a simple, 6MWT-derived measure of SFI is a strong predictor of death and provide incremental prognostic information over well-established risk markers in HF, including NP, and the MAGGIC score.<\/jats:p>","DOI":"10.1038\/s41598-024-53817-3","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T23:41:56Z","timestamp":1707262916000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Incremental prognostic value of functional impairment assessed by 6-min walking test for the prediction of mortality in heart failure"],"prefix":"10.1038","volume":"14","author":[{"given":"Domenico","family":"Scrutinio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Guida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"La Rovere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Adelaide Dalla","family":"Vecchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Forni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Raimondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simonetta","family":"Scalvini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Passantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"53817_CR1","doi-asserted-by":"publisher","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","volume":"118","author":"G Savarese","year":"2023","unstructured":"Savarese, G. et al. 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