Zusammenfassung:
Ein Vergleich biometrischer Faktoren wie Alter, Geschlecht, BMI, Ejektionsfraktion,
SF und linksventrikulärer enddistolischer Durchmesser, sowie dem NYHA Stadium
bei Patienten mit dilatativer Kardiomyopathie und gesunden Probanden auf
die während des 6-Minuten-Gehtest gelaufene Distanz ergab, dass Frauen mit dilatativer
Kardiomyopathie eine kürzere Gehstrecke zurücklegen als Männer gleichen
Alters und gleicher Erkrankung. Zudem laufen Patienten beiderlei Geschlechts mit
hohem NYHA Stadium kürzere Gehstrecken.
Bei direktem Vergleich von 6-Minuten Gehtest und Belastungs-EKG entsprach eine
kürzere Gehstrecke beim 6-Minuten Gehtest auch einer niedrigeren maximal erreichten
Leistungsstufe im Belastungselektrokardiogramm. Ferner bildete sich eine
längere Gehstrecke auch in einer höheren Belastung auf der modifizierten Borgskala
ab.
Auch bei den herzgesunden Familienangehörigen liefen Frauen kürzere Strecken im
Gehtest als Männer. Sowohl Frauen als auch Männer mit normaler oder nur gering
erniedrigter Verkürzungsfraktion liefen längere Gehstrecken als Personen beiderlei
Geschlechts mit reduzierter Verkürzungsfraktion.
Bei der Verlaufsuntersuchung entsprachen Verbesserungen bzw. Verschlechterungen
im NYHA Stadium auch Verlängerungen bzw. Verkürzungen der Gehstrecke. Besonders
bemerkenswert war, dass die Laufstrecke im 6-Minuten-Gehtest sich bereits
verbesserte, bevor der Patient die Verbesserung des NYHA Stadiums wahrnahm und
zu Protokoll gab.
Zusammenfassend sind die Ergebnisse der Arbeit:
1. NYHA Stadium höheren Grades und weibliches Geschlecht haben bei den
Patienten mit dilatativer Kardiomyopathie einen gleichgerichteten negativen
Einfluss auf die Länge der zurückgelegten Strecke beim 6-Minuten-Gehtest.
2. Auch bei den Familienangehörigen hatte eine verminderte Verkürzungsfraktion
und das weibliche Geschlecht einen negativen Einfluss auf die Länge der
zurückgelegten Strecke beim 6-Minuten-Gehtest.
3. Die Ergebnisse des 6-Minuten-Gehtests korrelieren gut mit der Belastbarkeit
bei der fahrradergometrischen Belastung und Einstufung auf der modifizierten
Borgskala.
4. Verbesserungen der Laufstrecke traten bereits auf, bevor der Patient die Verbesserung
des NYHA Stadiums wahrnahm.
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