Convergent and predictive validity of the 1-Minute Sit-to-Stand Test in Patients with Acute Decompensated Heart Failure

OBJECTIVES: To evaluate the convergent validity and prognostic validity of the one-minute sit-to-stand test (1-min STST) as a practical functional assessment tool in patients hospitalized with acute decompensated heart failure (ADHF) during the early post-discharge period. DESIGN: Prospective cohort study SETTING: West China Hospita of Sichuan University. PARTICIPANTS: A total of 153 patients hospitalized with ADHF. INTERVENTIONS: At hospital discharge, participants underwent assessment with the 1-min STST, Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). All patients were followed for 180 days after discharge. MAIN OUTCOME MEASURES: The primary outcome was a 180-day composite endpoint of all-cause rehospitalization or death. Pearson correlation examined associations between 1-min STST repetitions, SPPB score, and 6MWD. ROC analysis assessed their ability to predict 180-day composite events (rehospitalization or death), with optimal cutoffs from the Youden Index and AUCs compared by DeLong's test. ROC thresholds were used in Kaplan-Meier analyses (log-rank test), and Cox models estimated adjusted hazard ratios. Statistical significance was set at P ≤ 0.05. RESULTS: 153 patients completed both the 1-min STST, SPPB and 6MWT, with mean values of 19.9 repetitions, 10.3 points, and 356.4 meters, respectively. The 1-min STST demonstrated strong convergent validity with 6MWD (r=0.727, P<0.001). The 1-min STST showed good predictive performance for 180-day composite endpoint (AUC=0.786), comparable to 6MWT (AUC=0.708). Patients achieving ≥16 repetitions had significantly higher cumulative survival and better functional capacity. CONCLUSIONS: The 1-min STST is a field exercise test that strongly correlates with the 6MWT and provides prognostic insight in patients with ADHF. A threshold of ≥16 repetitions identifies patients with better survival/less hospitalizations, supporting its utility in clinical risk stratification.