Ferreira JP, et al. - Researchers assessed the predictive value of baseline and changing 6-minute walk test (6MWT) distance for the composite of heart failure (HF) hospitalization and/or death in patients with heart failure. In the BIOSTAT-CHF study, a 6MWT was performed at baseline (n=1,714) and 9 months (n=1,520). The associations of 6MWT distance with the outcomes were assessed using Cox proportional hazards models. Study participants were followed up for median 21 months. At baseline, the median (pct_25-75) of the 6MWT distance was 300 m (200–388 m). Older age, female sex, higher heart rate, New York Heart Association class III/IV, orthopnea, ischemic heart disease, a previous stroke, current malignancy, and higher N-terminal pro-B-type natriuretic peptide constituted the independent predictors of a shorter 6MWT distance. According to findings, the 6MWT distance at baseline and a decline in walking distance were both related to worse prognosis but failed to improve the prognostic models. Treatment up-titration did not modify 6MWT distance. A possibly limited utility of 6MWT distance in assessing the benefits of pharmacologic treatment up-titration was suggested.