{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:45:21Z","timestamp":1793882721354,"version":"4.7.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 6-min walk test distance (6MWD) was identified as a predictor of mortality in transthyretin amyloid cardiomyopathy (ATTR-CM). However, its real-world applicability remains uncertain, as only therapy-na\u00efve patients were included in the primary analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from a prospective ATTR-CM registry were analyzed and included if a 6MWT was completed at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 252 patients [79.8\u202fyears, interquartile range (IQR): 75.4\u201383.7] were included. After a median of 21.7 (IQR: 12.7\u201334.1) months, 61 (24.2%) patients died. A 6MWD of &amp;lt;350\u202fm was associated with worse survival [hazard ratio (HR): 3.29, 95% confidence interval (CI): 1.94\u20135.55, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001], even after adjusting for National Amyloidosis Centre stage (HR: 2.30, 95% CI: 1.29\u20134.10, <jats:italic>p<\/jats:italic>\u202f=\u202f0.005). The \u03946MWD thresholds of &amp;lt;\u221235\u202fmeters\/\u22125% were only associated with mortality after adjusting for change in treatment status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The 6MWD is independently associated with mortality in ATTR-CM irrespective of treatment status. A baseline 6MWD of &amp;lt;350\u202fm is associated with a ~3-fold risk for all-cause mortality. However, our results suggest that the \u03946MWD should only be used in patients on stable background therapy for the estimation of prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1639586","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:59:57Z","timestamp":1757311197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The 6-min walk test in transthyretin cardiac amyloidosis: prognostic utility put to the real-world 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