Can influence anxiety and depression the six-minute walking test performance in post-surgical heart valve patients? A pilot study

Various functional indicators are utilized to measure outcome in cardiac rehabilitation. Little information exists regarding the role played by psychological variables during the rehabilitative period, after cardiac valve surgery. The present study aims at exploring the relationship existing between different levels of functional capacity measured by six-minute walking test, (6MWT) and emotional aspects such as anxiety and depression. Materials and methods. 126 post-surgical heart valve patients underwent at the beginning and at the end of the rehabilitative programme: 1) 6MWT; 2) assessment of anxiety and depression (A-D Questionnaire according to the CBA-2.0 Primary Scale). Results. Cardiac rehabilitation was associated with a general and significant improvement in the 6MWT (273+98 metres versus 363+96; p<0.001) and the functional performance parameters (diastolic blood pressure; p<0.001 and fatigue p<0.001). Simultaneously there was a significant improvement of patient-reported quality of life, revealed by the A-D questionnaire in both male and female patients. The Depression Questionnaire score is predictive of functional capacity. It was demonstrated that no matter what the clinical condition of the patient, the depression score influences the patient’s performance during the 6MWT, not only regards the distance covered (p=.008), but also fatigue expressed by the Borg RPE index (p=.044). Conclusion. Depression, an emotional variable, selfevaluated by the standardized questionnaire can, even if only partially, influence the 6MWT, a functional indicator of exercise tolerance, widely utilized in cardiac rehabilitation.