6-Minuten-Gehtest in der pneumologischen und kardiologischen Diagnostik

Einleitung

Patienten mit chronischen Lungenerkrankungen oder Herzinsuffizienz sind in ihrer Belastbarkeit eingeschränkt. Diesen beiden Patientengruppen kommt eine große epidemiologische und ökonomische Bedeutung zu. Die COPD ist verantwortlich für 5 % aller ambulanten Arztbesuche und mehr als 13 % aller Krankenhauseinweisungen [3]. In der Mortalitätsreihung nimmt die COPD den 3. Platz ein, an der Morbidität gemessen Platz 5. 15 % der Kosten im Gesundheitssystem verursachen die Lungenerkrankungen, diese angeführt von der COPD [4]. Der 6-Minuten-Gehtest (6MGT) hilft, die funktionellen Reserven und das Ausmaß der Belastbarkeit von Patienten mit chronischen Lungen- und Herzerkrankungen in ihrem individuellen Alltag zu beurteilen, und dies in unkomplizierter Weise.

Klassische Ergometrieuntersuchungen auf dem Fahrrad oder auf dem Laufband sind gerade für ältere, gebrechliche oder schwergradig limitierte Menschen in aller Regel ungeeignet. Derartige Funktionsuntersuchungen spiegeln somit die Belastbarkeit im Alltag bei den genannten Patientengruppe nicht wider. Der 6MGT ist hierfür der geeignetere Maßstab [1].

Versuche mit Hilfe des 6MGT die Prognose bzw. Überlebenszeit, die Operabilität für Lungenteilresektionen oder die Indikation zur Lungentransplantation zu beurteilen, zeigen statistisch Korrelationen bzw. diskriminieren über alle Schweregrade chronischer Lungenerkrankungen. Die Voraussetzungen, die erlauben die statistische Auswertung ganzer Gruppen auf eine individuelle, klinisch-relevante Einschätzung zu übertragen, sind allerdings nicht gegeben [2].

Die Hauptvorteile des 6MGT sind dessen Einfachheit, der geringe Aufwand an Ressourcen (Korridor, Supervision) und die Möglichkeit, den 6MGT nahezu überall anwenden zu können. Eine finanzielle Investition, eine spezielle technische Ausstattung oder ein hoher personeller Einsatz sind nicht erforderlich [5].

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