{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:25:07Z","timestamp":1757611507813,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005565","name":"Johnson & Johnson Innovative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005565","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,6,18]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Cardiopulmonary involvement (CPI) is a major cause of morbidity and mortality in systemic sclerosis (SSc). The 6 min walk test (6MWT) is widely used to assess functional capacity, but its ability to detect incident CPI remains uncertain. This study aimed to evaluate the determinants and trajectory of 6MWT parameters over time and its diagnostic utility in identifying incident CPI in SSc.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two large prospective SSc cohorts were analysed. Multivariable regression identified factors associated with baseline 6MWT parameters. Longitudinal changes were assessed using linear mixed models, and diagnostic accuracy for incident CPI was evaluated using predefined thresholds for a decline in 6 min walking distance (6MWD) (\u226533 m) and oxygen desaturation (&lt;95%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with CPI walked 89 m less than those without (95%\u2009CI \u2212116 to 61) and exercise-induced desaturation was more frequent in CPI (OR 17.0, 95%\u2009CI 8.7 to 33). Over time, 6MWD increased slightly by 3.0 m per year (95%\u2009CI 1.7 to 4.3). Linear mixed model analysis showed an independent association of 6MWD (\u221233\u2009m, 95%\u2009CI \u221245 to 21) and occurrence of exercise-induced desaturation (OR 15, 95%\u2009CI 8.5 to 30) in patients with CPI. A \u226533 m decline in 6MWD had 34.7% sensitivity and 79% specificity for detecting incident CPI, while new desaturation had 10.6% sensitivity and 92.6% specificity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>6MWT parameters are associated with CPI in SSc. A stable 6MWD and absence of desaturation may help rule out CPI, but their low sensitivity suggests that 6MWT alone is insufficient for screening and should be complemented by additional diagnostic modalities.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-005154","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:45:22Z","timestamp":1752579922000},"page":"e005154","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Value of the 6 min walk test in detecting cardiopulmonary involvement in patients with systemic sclerosis"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3098-0172","authenticated-orcid":false,"given":"Saad","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0328-7062","authenticated-orcid":false,"given":"Sophie I E","family":"Liem","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9446-7351","authenticated-orcid":false,"given":"Jacopo","family":"Ciaffi","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy"},{"name":"DIBINEM, Alma Mater Studiorum Universit\u00e0 di Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva M","family":"Hoekstra","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A A","family":"Schouffoer","sequence":"additional","affiliation":[{"name":"Rheumatology, Haga Hospital, the Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-5248","authenticated-orcid":false,"given":"Sytske Anne","family":"Bergstra","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Ueckert","sequence":"additional","affiliation":[{"name":"Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten","family":"Ninaber","sequence":"additional","affiliation":[{"name":"Pulmonology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-2083","authenticated-orcid":false,"given":"Cosimo","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Zurich, Zurich, Switzerland"},{"name":"Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzana","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Zurich, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-8310","authenticated-orcid":false,"given":"Oliver","family":"Distler","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-7520","authenticated-orcid":false,"given":"Tom WJ","family":"Huizinga","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert","family":"Vliegen","sequence":"additional","affiliation":[{"name":"Cardiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5624-1415","authenticated-orcid":false,"given":"Jeska","family":"De Vries-Bouwstra","sequence":"additional","affiliation":[{"name":"Rheumatology C01-51, LUMC, Leiden, The 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