Cardiac function

心功能
  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fhar.2024.1345897。].
    [This corrects the article DOI: 10.3389/fphar.2024.1345897.].
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:心血管疾病(CVD)仍然是全球死亡的首要原因。牛磺酸,一种氨基酸,通过钙调节等机制对心血管健康充满希望,血压降低,和抗氧化和抗炎作用。尽管有这些潜在的好处,以往的研究结果不一致.这项对随机对照试验(RCTs)的荟萃分析旨在评估牛磺酸对血流动力学参数和心功能分级的定量影响的现有证据。这表明总体心血管健康和表现。
    方法:我们在多个数据库中进行了电子搜索,包括Embase,PubMed,WebofScience,科克伦中部,和ClinicalTrials.gov,从成立到2024年1月2日。我们的分析集中在关键的心血管结局,例如心率(HR),收缩压(SBP),舒张压(DBP),左心室射血分数(LVEF),和纽约心脏协会(NYHA)功能分类。基于治疗期间给予的总牛磺酸剂量,应用Meta回归来探索剂量依赖性关系。亚组分析,根据患者的基线疾病状态进行分层,也进行了。
    结果:分析包括来自20项随机对照试验的808名参与者的合并样本。牛磺酸显示HR显着降低(加权平均差[WMD]=-3.579bpm,95%置信区间[CI]=-6.044至-1.114,p=0.004),SBP(WMD=-3.999mmHg,95%CI=-7.293至-0.706,p=0.017),DBP(WMD:-1.435mmHg,95%CI:-2.484至-0.386,p=0.007),NYHA(WMD:-0.403,95%CI:-0.522至-0.283,p<0.001),LVEF显著增加(大规模杀伤性武器:4.981%,95%CI:1.556至8.407,p=0.004)。Meta回归表明HR呈剂量依赖性降低(系数=-0.0150/g,p=0.333),SBP(系数=-0.0239/g,p=0.113),DBP(系数=-0.0089/g,p=0.110),和NYHA(系数=-0.0016/g,p=0.111),与LVEF呈正相关(系数=0.0285/g,p=0.308)。与对照相比,没有观察到显著的不良反应。在亚组分析中,牛磺酸显着改善心力衰竭患者和健康个体的HR。牛磺酸显着降低健康个体的SBP,心力衰竭患者,和那些患有其他疾病的人,而高血压患者的DBP显着降低,心力衰竭患者的LVEF显着增加,心力衰竭患者和其他疾病患者的NYHA功能分级均得到改善。
    结论:牛磺酸在预防高血压和增强心脏功能方面具有显著作用。容易患CVD的个体可能会发现在其日常治疗方案中包括牛磺酸是有利的。
    BACKGROUND: Cardiovascular disease (CVD) remains the foremost cause of mortality globally. Taurine, an amino acid, holds promise for cardiovascular health through mechanisms such as calcium regulation, blood pressure reduction, and antioxidant and anti-inflammatory effects. Despite these potential benefits, previous studies have yielded inconsistent results. This meta-analysis of randomized controlled trials (RCTs) aims to evaluate the existing evidence on the quantitative effects of taurine on hemodynamic parameters and cardiac function grading, which are indicative of overall cardiovascular health and performance.
    METHODS: We conducted an electronic search across multiple databases, including Embase, PubMed, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov, from their inception to January 2, 2024. Our analysis focused on key cardiovascular outcomes, such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) Functional Classification. Meta-regression was applied to explore dose-dependent relationships based on the total taurine dose administered during the treatment period. A subgroup analysis, stratified according to the baseline disease status of patients, was also conducted.
    RESULTS: The analysis included a pooled sample of 808 participants from 20 randomized controlled trials. Taurine demonstrated a significant reduction in HR (weighted mean difference [WMD] = -3.579 bpm, 95% confidence interval [CI] = -6.044 to -1.114, p = 0.004), SBP (WMD = -3.999 mm Hg, 95% CI = -7.293 to -0.706, p = 0.017), DBP (WMD: -1.435 mm Hg, 95% CI: -2.484 to -0.386, p = 0.007), NYHA (WMD: -0.403, 95% CI: -0.522 to -0.283, p < 0.001), and a significant increase in LVEF (WMD: 4.981%, 95% CI: 1.556 to 8.407, p = 0.004). Meta-regression indicated a dose-dependent reduction in HR (coefficient = -0.0150 per g, p = 0.333), SBP (coefficient = -0.0239 per g, p = 0.113), DBP (coefficient = -0.0089 per g, p = 0.110), and NYHA (coefficient = -0.0016 per g, p = 0.111), and a positive correlation with LVEF (coefficient = 0.0285 per g, p = 0.308). No significant adverse effects were observed compared to controls. In subgroup analysis, taurine significantly improved HR in heart failure patients and healthy individuals. Taurine significantly reduced SBP in healthy individuals, heart failure patients, and those with other diseases, while significantly lowered DBP in hypertensive patients It notably increased LVEF in heart failure patients and improved NYHA functional class in both heart failure patients and those with other diseases.
    CONCLUSIONS: Taurine showed noteworthy effects in preventing hypertension and enhancing cardiac function. Individuals prone to CVDs may find it advantageous to include taurine in their daily regimen.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    妊娠期糖尿病与后代心脏功能受损有关。这项系统评价的目的是确定妊娠糖尿病对超声心动图测量的后代心脏功能的影响。
    PubMed,Embase,从1992年到2023年6月27日搜索了CochraneCENTRAL和WebofScience数据库。包括通过超声心动图报告子代(年龄<18岁)心脏功能的研究,比较了妊娠中任何类型的糖尿病和健康对照妊娠。研究选择,质量评估和偏倚风险由两名评审员独立进行.在可能的情况下进行荟萃分析。
    31项观察性研究包括1,679例病例和2,694例对照。在生命的第一周(23项研究,n=2,663),室间隔舒张直径(肥大)增加,而心肌性能指数(整体功能)和LVE/A比(舒张功能)降低。左心室射血分数(收缩功能)无差异。在1-6个月(4项研究,n=454)研究发现肥大,全球功能下降,但收缩或舒张功能没有差异.在1-8年(7项研究,n=1,609)没有发现差异。现有数据不允许根据糖尿病类型进行亚分析,治疗,或血糖控制。
    妊娠糖尿病与6个月以下婴儿的心脏肥大和整体心脏功能受损有关。少数报道年龄较大儿童的研究发现,所调查的参数没有差异。需要采用更先进的超声心动图或MRI的纵向研究来评估长期心脏健康的后果。
    https://www.crd.约克。AC.英国/,标识符(CRD42022312471)。
    UNASSIGNED: Diabetes in pregnancy is associated with impaired offspring cardiac function. The objective of this systematic review was to determine the effect of diabetes in pregnancy on cardiac function in the offspring measured by echocardiography.
    UNASSIGNED: PubMed, Embase, Cochrane CENTRAL and Web of Science databases were searched from 1992 to June 27, 2023. Studies reporting offspring (age < 18 years) cardiac function by echocardiography compared between any type of diabetes in pregnancy and healthy control pregnancies were included. Study selection, quality assessment and risk of bias was independently performed by two reviewers. Meta-analyses was performed where possible.
    UNASSIGNED: Thirty-one observational studies were included 1,679 cases and 2,694 controls. In the first week of life (23 studies, n = 2,663), intraventricular septum diastolic diameter (hypertrophy) was increased, while myocardial performance index (global function) and LV E/A-ratio (diastolic function) were decreased. No difference was found for left ventricular ejection fraction (systolic function). At 1-6 months (4 studies, n = 454) studies found hypertrophy, and decreased global function, but no difference in systolic or diastolic function. At 1-8 years (7 studies, n = 1,609) no difference was found. The available data did not allow for sub-analysis based on the type of diabetes, treatment, or glycemic control.
    UNASSIGNED: Diabetes in pregnancy is associated with cardiac hypertrophy and impaired global cardiac function in infants up to six months old. The few studies reporting on older children found no difference in the parameters investigated. Longitudinal studies employing more advanced echocardiographic measures or MRI are needed to evaluate consequences for long-term cardiac health.
    UNASSIGNED: https://www.crd.york.ac.uk/, identifier (CRD42022312471).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    对心力衰竭(HF)患者补充维生素D效果的系统评估。
    在国家医学图书馆进行了搜索,WebofScience,科克伦图书馆,谷歌学者,中国国家知识基础设施,和万方数据库。我们使用ReviewManager5.4软件分析数据。所有这些都是从最早的记录到2023年3月。结果指标分析左心室射血分数(LVEF),左心室舒张末期内径(LVEDD),B型脑钠肽(BNP)水平和25-羟基维生素D(25(OH)D)水平。
    纳入了10项1099名患者的研究。LVEF(均差(MD)=0.74,95%CI:-0.29至1.76,p=0.41),LVEDD(MD=-0.59,95%CI:-1.83至0.66,p=0.25),BNP(MD=-0.08,95%CI:-0.24至0.08,p=0.34),25(OH)D(MD=0.41,95%CI:-0.28至1.11,p=0.25)没有统计学意义。LVEF的结果没有异质性,LVEDD和BNP指标。
    补充维生素D可能对HF患者的临床治疗没有帮助。
    UNASSIGNED: Systematic evaluation of the effects of vitamin D supplementation in heart failure (HF) patients.
    UNASSIGNED: Searches were conducted on National Library of Medicine, Web of Science, Cochrane Library, Google Scholar, China National Knowledge Infrastructure, and WANFANG databases. We analyzed data by using Review Manager 5.4 software. All are from the earliest records to March 2023. Outcome indicators analyzed the left ventricular ejection fraction (LVEF), the left ventricular end-diastolic internal diameter (LVEDD), the B-type brain natriuretic peptide (BNP) level and the 25-hydroxy vitamin D (25(OH)D) level.
    UNASSIGNED: Ten studies with 1099 patients were included. LVEF (mean difference (MD) = 0.74, 95% CI: -0.29 to 1.76, p = 0.41), LVEDD (MD = -0.59, 95% CI: -1.83 to 0.66, p = 0.25), BNP (MD = -0.08, 95% CI: -0.24 to 0.08, p = 0.34), 25(OH)D (MD = 0.41, 95% CI: -0.28 to 1.11, p = 0.25) are not statistically significant. And there is no heterogeneity in the results of LVEF, LVEDD and BNP indicators.
    UNASSIGNED: Vitamin D supplementation may not be helpful in the clinical management of patients with HF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目标:在过去的十年中,许多超声心动图研究采用斑点追踪超声心动图(STE)评估二尖瓣脱垂(MVP)患者的心肌变形特性,报告不明确的结果。因此,我们进行了系统综述和荟萃分析,以总结这些研究的主要发现,并研究MVP对左心室(LV)整体纵向应变(GLS)的总体影响.
    方法:所有超声心动图研究评估MVP个体的常规回波多普勒参数和心肌应变指数与没有MVP的控件,从PubMed和EMBASE数据库中选择,包括在内。使用美国国立卫生研究院(NIH)病例对照研究质量评估评估偏倚的风险。将连续数据(LV-GLS)合并为比较MVP组与健康对照的标准化平均差异(SMD)。使用随机效应模型计算LV-GLS的整体SMD。
    结果:分析了15项研究的全文,其中包括1088名MVP患者和591名健康对照。平均LV-GLS幅度显著,即使谦虚,与对照组相比,MVP个体降低(19.4±3.4%vs.21.1±2.8%,P<0.001)。MVP对LV-GLS的总体作用是小到中等(SMD-0.54,95CI-0.76,-0.32,P<0.001)。在纳入的研究中发现了实质性的异质性,总体I2统计值为75.9%(P<0.001)。回归截距的Egger检验得出的P值为0.58,表明没有发表偏倚。在荟萃回归分析中,没有主持人(年龄,MVP个体中女性的百分比,身体质量指数,MVP个体的心率和收缩压,二尖瓣反流的程度,用于应变超声心动图成像的超声机器类型以及最终的β受体阻滞剂治疗)与疗效改善显着相关(所有P<0.05)。区域应变分析,由三分之二的研究进行,强调了在所有方向上LV基底下外侧段水平的心肌应变参数的降低(纵向,周向和径向),顶端保留。
    结论:在MVP个体中检测到的纵向应变损害是区域性的,而不是全球性的,左心室基底下外侧段的特殊受累和相对的根尖保留模式。
    OBJECTIVE: During the last decade, a number of echocardiographic studies have employed speckle tracking echocardiography (STE) for assessing myocardial deformation properties in individuals with mitral valve prolapse (MVP), reporting not univocal results. Accordingly, we performed a systematic review and meta-analysis to summarize the main findings of these studies and to examine the overall influence of MVP on left ventricular (LV) global longitudinal strain (GLS).
    METHODS: All echocardiographic studies assessing conventional echoDoppler parameters and myocardial strain indices in MVP individuals vs. controls without MVP, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case-Control Studies. Continuous data (LV-GLS) were pooled as a standardized mean difference (SMD) comparing MVP group with healthy controls. The overall SMD of LV-GLS was calculated using the random-effect model.
    RESULTS: The full-texts of 15 studies with 1088 individuals with MVP and 591 healthy controls were analyzed. Average LV-GLS magnitude was significantly, even though modestly, reduced in MVP individuals in comparison to controls (19.4 ± 3.4% vs. 21.1 ± 2.8%, P < 0.001). The overall effect of MVP on LV-GLS was small-to-medium (SMD - 0.54, 95%CI -0.76,-0.32, P < 0.001). Substantial heterogeneity was detected for the included studies, with an overall I2 statistic value of 75.9% (P < 0.001). Egger\'s test for a regression intercept gave a P-value of 0.58, indicating no publication bias. On meta-regression analysis, none of the moderators (the age, the percentage of females among MVP individuals, body mass index, heart rate and systolic blood pressure of MVP individuals, the degree of mitral regurgitation, the type of ultrasound machine employed for strain echocardiographic imaging and finally the beta blocker treatment) was significantly associated with effect modification (all P < 0.05). Regional strain analysis, performed by two-third of the studies, highlighted a more enhanced reduction in myocardial strain parameters at level of the LV basal infero-lateral segments in all directions (longitudinal, circumferential and radial), with apical sparing.
    CONCLUSIONS: The longitudinal strain impairment detected in MVP individuals is more regional than global, with peculiar involvement of the LV basal infero-lateral segments and relative apical sparing pattern.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:养心氏片(YXST)治疗慢性心力衰竭(CHF)的具体疗效尚不明确。
    目的:系统评价YXST治疗CHF的疗效和安全性。
    方法:截至2023年11月,从8个公共数据库中检索了研究YXST治疗CHF的随机对照试验(RCT)。使用ReviewManager5.3对纳入的临床研究进行Meta分析。
    结果:纳入20个RCT和1845个患者。Meta分析结果显示,YXST联合用药组,与常规药物组相比,临床有效率显着增加23%[相对风险(RR)=1.23,95CI:1.17-1.29],P<0.00001),左心室射血分数为6.69%[均差(MD)=6.69,95CI:4.42-8.95,P<0.00001],6分钟步行试验为49.82m(MD=49.82,95%C:38.84-60.80,P<0.00001),N末端B型利钠肽前体减少1.03ng/L[标准化MD(SMD)=-1.03,95CI:-1.32至-0.74,P<0.00001],脑钠肽80.95ng/L(MD=-80.95,95CI:-143.31至-18.59,P=0.01),左心室舒张末期内径3.92mm(MD=-3.92,95CI:-5.06至-2.78,P<0.00001),左心室收缩末期内径为4.34mm(MD=-4.34,95CI:-6.22至-2.47,P<0.00001)。关于安全,两组均未报告治疗期间发生严重不良事件(RR=0.54,95CI:0.15~1.90,P=0.33).此外,Egger检验结果无显著发表偏倚(P=0.557)。
    结论:YXST可有效改善CHF患者的临床症状和心功能,同时保持良好的安全性,提示其作为CHF治疗策略的潜力。
    BACKGROUND: The specific benefits of Yangxinshi tablet (YXST) in the treating chronic heart failure (CHF) remain uncertain.
    OBJECTIVE: To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.
    METHODS: Randomized controlled trials (RCTs) investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023. Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.
    RESULTS: Twenty RCTs and 1845 patients were included. The meta-analysis results showed that the YXST combination group, compared to the conventional drug group, significantly increased the clinical efficacy rate by 23% [relative risk (RR) = 1.23, 95%CI: 1.17-1.29], P < 0.00001), left ventricular ejection fraction by 6.69% [mean difference (MD) = 6.69, 95%CI: 4.42-8.95, P < 0.00001] and 6-min walk test by 49.82 m (MD = 49.82, 95%C: 38.84-60.80, P < 0.00001), and reduced N-terminal pro-B-type natriuretic peptide by 1.03 ng/L [standardized MD (SMD) = -1.03, 95%CI: -1.32 to -0.74, P < 0.00001], brain natriuretic peptide by 80.95 ng/L (MD = -80.95, 95%CI: -143.31 to -18.59, P = 0.01), left ventricular end-diastolic diameter by 3.92 mm (MD = -3.92, 95%CI: -5.06 to -2.78, P < 0.00001), and left ventricular end-systolic diameter by 4.34 mm (MD = -4.34, 95%CI: -6.22 to -2.47, P < 0.00001). Regarding safety, neither group reported any serious adverse events during treatment (RR = 0.54, 95%CI: 0.15-1.90, P = 0.33). In addition, Egger\'s test results indicated no significant publication bias (P = 0.557).
    CONCLUSIONS: YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile, suggesting its potential as a therapeutic strategy for CHF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    目的:本研究的目的是全面评估CDDP在接受PCI的AMI患者中的有效性和安全性。方法:在CNKI网站上进行计算机检索,WF,VIP,CBM,PubMed,Embase,WebofScience,和Cochrane库数据库,用于截至2023年5月CDDP辅助治疗AMI的RCT。STATA17.0用于进行荟萃分析,敏感性分析,亚组分析,元回归,和出版偏见评估。TSA0.9.5.10Beta用于试验序贯分析(TSA)。荟萃结果的证据可信度通过等级(建议评估的分级,开发和评估)根据说明。结果:meta分析结果显示,CDDP联合常规西医治疗(CWT)在提高LVEF和TCER、降低LVEDD方面优于CWT,hs-CRP,IL-6和TNF-α。TCER的证据质量适中,LVEF,LVEDD,IL-6和TNF-α水平较低。TSA结果显示,本研究收集的样本总数符合meta分析的要求,排除了假阳性的可能性,进一步证实CDDP用于PCI治疗AMI的疗效.结论:CDDP辅助治疗AMI在改善AMI患者PCI术后心功能和减轻炎症反应方面显示出令人兴奋和安全的益处,但部分纳入研究的质量较差。在精心设计的RCT进一步确认之前,应谨慎解释结果。系统审查注册:[https://www。crd.约克。AC.uk/PROSPERO/#recordDetails],标识符[CRD42023453293]。
    Objectives: The purpose of the study was to comprehensively evaluate efficacy and safety of CDDP in patients with AMI undergoing PCI. Methods: A computerised search was conducted on the CNKI, WF, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library databases for RCTs of CDDP adjuvant therapy for AMI up to May 2023. STATA 17.0 was used to perform meta-analyses, sensitivity analyses, subgroup analyses, meta-regression, and publication bias assessments. TSA 0.9.5.10 Beta was used for trial sequential analysis (TSA). Evidence confidence of meta results was evaluated by GRADE (Grading of Recommendations Assessment, Development and Evaluation) according to the instructions. Results: The results of the meta-analysis showed that CDDP combined with conventional western treatment (CWT) was superior to CWT in increasing LVEF and TCER and decreasing LVEDD, hs-CRP, IL-6 and TNF-α. The quality of evidence for TCER was moderate, LVEF, LVEDD, IL-6, and TNF-α were low. The TSA results showed that the total number of samples collected in this study met the requirements for meta-analysis and excluded the possibility of false positives, further confirming the efficacy of CDDP for the treatment of AMI undergoing PCI. Conclusion: Adjuvant treatment of AMI with CDDP has shown exciting and safe benefits in improving cardiac function and reducing inflammatory response in patients with AMI undergoing PCI, but the quality of some of the included studies was poor, and the results should be interpreted with caution until further confirmation by well-designed RCTs. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42023453293].
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    建议患者进行体育锻炼,以提高生活质量并取得更好的效果。本研究的目的是测量运动对身体能力的影响,房颤患者的心功能和心肺适应性。
    在PubMed,Embase,和WebofScience从1991年到2023年的RCT比较了体育锻炼结合AF常规治疗与常规治疗的单独治疗。荟萃分析遵循PRISMA指南。我们的主要结果是身体能力(通过6分钟步行测试测量,6MWT),心功能(通过左心室射血分数测量,LVEF)和心肺健康(通过峰值摄氧量和静息心率测量)。使用Cochrane协作工具进行质量评估。
    涉及672名患者的13项试验符合分析标准。结果表明,体育锻炼可以通过改善6MWT(m)表现来提高身体能力(MD=96.99,95%CI:25.55-168.43;Z=2.66;p=0.008);并提高峰值VO2(ml/kg/min)(MD=4.85,95%CI:1.55-8.14;Z=2.89;p=0.004),同时降低心率(每分钟心跳,静息bpm)(MD=-6.14,95%CI:-11.30至-0.98;Z=2.33;p=0.02)。然而,结果表明,有规律的运动可以改善临床住院患者的LVEF(%),实验组与对照组之间无统计学差异(MD=1.49,95%CI:-0.25-3.24;Z=1.68;p=0.09)。
    我们的荟萃分析表明,体育锻炼是一种有效的干预措施,可以提高AF患者的运动能力和心肺适应性。同时,我们也不排除运动对房颤患者心功能(LVEF)改善的积极作用.为此,医生应考虑运动对患者的积极影响,并在实际临床实践中就运动限制提出建议。
    UNASSIGNED: It is advised that patients engage in physical activity to enhance their quality of life and achieve better results. The purpose of the current study was to measure the efficacy of exercise on the physical ability, cardiac function and cardiopulmonary fitness of patients with AF.
    UNASSIGNED: A comprehensive systematic literature search was performed in PubMed, Embase, and Web of Science from 1991 to 2023 for RCTs comparing physical exercise combined with AF routine treatments to routine treatments alone. The meta-analysis was conducted following PRISMA guidelines. Our main outcomes were physical ability (measured by the 6-min walk test, 6MWT), cardiac function (measured by left ventricular ejection fraction, LVEF) and cardiopulmonary fitness (measured by peak oxygen uptake and resting heart rate). Quality assessments were conducted using the Cochrane Collaboration tool.
    UNASSIGNED: Thirteen trials involving 672 patients met the criteria for analysis. The results showed that physical exercise increased physical ability by improving the 6MWT (m) performance (MD = 96.99, 95% CI: 25.55-168.43; Z = 2.66; p = 0.008); and enhanced peak VO2 (ml/kg per min) (MD = 4.85, 95% CI: 1.55-8.14; Z = 2.89; p = 0.004) while reducing resting heart rate (beats per minute, bpm) (MD = -6.14, 95% CI: -11.30 to -0.98; Z = 2.33; p = 0.02). However, the results showed that regular exercise could improve LVEF (%) inpatients clinically, which had no statistic difference between experimental and control group (MD = 1.49, 95% CI: -0.25-3.24; Z = 1.68; p = 0.09).
    UNASSIGNED: Our meta-analysis shows that physical exercise is an effective intervention to improve the exercise ability and cardiopulmonary fitness for AF patients. Meanwhile, we also do not exclude the positive effect of exercise on the improvement of cardiac function (LVEF) in patients with AF. To this end, doctors should consider the positive impact of exercise on patients and give advice on exercise limits in practical clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:肌肉减少症与身体功能和运动耐量受损有关。本系统综述和荟萃分析的目的是检查肌肉减少症和下肢骨骼肌(ASM)与心脏功能生物标志物的关系。B型利钠肽(BNP)及其N末端片段(NT-proBNP),心力衰竭(HF)患者。
    结果:从开始到2023年5月,利用PubMed对观察性研究进行了系统的文献检索,WebofScience,Scopus,和Cochrane图书馆数据库。采用随机效应模型的荟萃分析用于计算合并效应(CRD42023418465)。总的来说,本系统综述和荟萃分析包括16项研究。我们的主要分析表明,HF中的肌少症与BNP水平显着升高有关(MD:87.76,95%CI20.74-154.78,I2=61%,P=0.01)和NT-proBNP(MD:947.45,95%CI98.97-1795.93,I2=35%,P=0.03)。同样,低ASM与BNP水平显著升高相关(MD:118.95,95%CI46.91-191.00,I2=93%,P<0.01)和NT-proBNP(MD:672.01,95%CI383.72-960.30,I2=2%,P<0.01)。纳入的队列研究的质量被认为是中等的,使用二进制AXIS检查表和Cochrane工具评估队列研究中的偏差风险。
    结论:在HF患者中,肌肉减少和ASM降低与血浆BNP和NT-proBNP水平明显升高有关。未来的研究需要研究肌肉减少症是否可能表达心脏功能的生物标志物失调。
    OBJECTIVE: Sarcopenia is linked to impaired physical function and exercise tolerance. The aim of this systematic review and meta-analysis was to examine the association of sarcopenia and low appendicular skeletal muscle (ASM) with biomarkers of cardiac function, B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP), in patients with heart failure (HF).
    RESULTS: From inception until May 2023, a systematic literature search of observational studies was undertaken utilizing the PubMed, Web of Science, Scopus, and Cochrane Library databases. A meta-analysis employing a random-effects model was used to compute the pooled effects (CRD42023418465). Overall, 16 studies were included in this systematic review and meta-analysis. Our main analysis showed that sarcopenia in HF was linked to significantly higher levels of BNP (MD: 87.76, 95% CI 20.74-154.78, I2 = 61%, P = 0.01) and NT-proBNP (MD: 947.45, 95% CI 98.97-1795.93, I2 = 35%, P = 0.03). Similarly, low ASM was associated with significantly higher levels of BNP (MD: 118.95, 95% CI 46.91-191.00, I2 = 93%, P < 0.01) and NT-proBNP (MD: 672.01, 95% CI 383.72-960.30, I2 = 2%, P < 0.01). The quality of the included cohort studies was considered moderate, using the binary AXIS checklist and the Cochrane Tool to Assess the Risk of Bias in Cohort Studies.
    CONCLUSIONS: In patients with HF, sarcopenia and reduced ASM are associated with considerably higher plasma levels of BNP and NT-proBNP. Future research is required to investigate whether sarcopenia may express dysregulated biomarkers of cardiac function.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    目的:许多临床研究已经探索了钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)在慢性心力衰竭(CHF)患者中的作用,有或没有2型糖尿病(T2DM),和SGLT2i被证明显着减少CHF住院,心血管死亡,心血管死亡率,伴或不伴T2DM患者的全因死亡率和心肌梗死。然而,只有少数人研究了SGLT-2i对HF疾病特异性健康状况和心功能的影响.本荟萃分析旨在评估SGLT2i对CHF患者疾病特异性健康状况和心功能的影响。
    方法:通过在PubMed,EMBASE,中部,Scopus,和WebofScience,和两个中文数据库(CNKI和万方),临床试验(http://www.
    结果:gov)也进行了搜索。
    结果:共有18项随机对照试验(RCT),包括23,953名参与者,纳入荟萃分析。SGLT2抑制剂与对照组或安慰剂组在有或没有T2DM的CHF中的作用进行比较。SGLT2抑制剂组显示b型利钠肽原(NT-proBNP)水平显着降低136.03pg/ml(95%置信区间[CI]:-253.36,-18.70;P=0.02)。此外,SGLT2抑制剂组中更多的患者显示NT-proBNP下降≥20%(RR=1.45,95%CI[0.92,2.29],p=0.072)。然而,对B型利钠肽(BNP)的影响无统计学差异.SGLT-2抑制剂的使用导致LVEF显著改善2.79%(95%CI[0.18,5.39];P=0.036)。就健康状况而言,根据堪萨斯城心肌病问卷(KCCQ)和6分钟步行距离的评估,SGLT2抑制剂导致KCCQ临床总结(KCCQ-CS)评分显著改善(WMD=1.7,95%CI[1.67,1.73],P<0.00001),KCCQ总体总结(KCCQ-OS)得分(WMD=1.73,95%CI[0.94,2.52],P<0.00001),和KCCQ总症状(KCCQ-TS)评分(WMD=2.88,95%CI[1.7,4.06],P<0.00001)。此外,发生KCCQ-CS和KCCQ-OS评分增加≥5分的相对危险度(RR)为1.25(95%CI[1.11,1.42],P<0.00001)和1.15(95%CI[1.09,1.22],P<0.00001),分别。总的来说,与对照组/安慰剂相比,SGLT2抑制剂使6分钟步行距离从基线增加23.98m(95%CI[8.34,39.62];P=0.003)。
    结论:SGLT2抑制剂治疗提供了改善NT-proBNP水平的有效策略,堪萨斯城心肌病问卷评分和6分钟步行距离CHF伴或不伴T2DM。这些研究结果表明,SGLT2i改善CHF伴或不伴T2DM患者的心功能和健康状况,并为临床医生制定CHF患者的治疗决策提供有价值的指导。
    Numerous clinical studies have explored sodium-glucose cotransporter 2 inhibitor (SGLT2i) in patients with chronic heart failure (CHF), with or without type 2 diabetes mellitus (T2DM), and SGLT2i were proved to significantly reduce CHF hospitalization, cardiovascular death, cardiovascular mortality, all-cause mortality and myocardial infarction in patients with or without T2DM. However, only a limited few have investigated the effects of SGLT-2i on HF disease-specific health status and cardiac function. This meta-analysis aims to assess the effects of SGLT2i on disease-specific health status and cardiac function in CHF patients.
    A comprehensive search was conducted of trials by searching in PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, and two Chinese databases (CNKI and Wanfang), Clinical Trials ( http://www.
    gov ) were also searched.
    A total of 18 randomized controlled trials (RCTs) involving 23,953 participants were included in the meta-analysis. The effects of SGLT2 inhibitors were compared with control or placebo groups in CHF with or without T2DM. The SGLT2 inhibitors group exhibited a significant reduction in pro b-type natriuretic peptide (NT-proBNP) levels by 136.03 pg/ml (95% confidence interval [CI]: -253.36, - 18.70; P = 0.02). Additionally, a greater proportion of patients in the SGLT2 inhibitors group showed a ≥ 20% decrease in NT-proBNP (RR = 1.45, 95% CI [0.92, 2.29], p = 0.072). However, no statistically significant difference was observed for the effects on B-type natriuretic peptide (BNP). The use of SGLT-2 inhibitors led to a noteworthy improvement in LVEF by 2.79% (95% CI [0.18, 5.39];P = 0.036). In terms of health status, as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) and 6-minute walk distance, SGLT2 inhibitors led to a significant improvement in KCCQ clinical summary (KCCQ-CS) score (WMD = 1.7, 95% CI [1.67, 1.73], P < 0.00001), KCCQ overall summary (KCCQ-OS) score (WMD = 1.73, 95% CI [0.94, 2.52], P < 0.00001), and KCCQ total symptom (KCCQ-TS) score (WMD = 2.88, 95% CI [1.7, 4.06], P < 0.00001). Furthermore, the occurrence of KCCQ-CS and KCCQ-OS score increases ≥ 5 points had relative risks (RR) of 1.25 (95% CI [1.11, 1.42], P < 0.00001) and 1.15 (95% CI [1.09, 1.22], P < 0.00001), respectively. Overall, SGLT2 inhibitors increased the 6-minute walk distance by 23.98 m (95% CI [8.34, 39.62]; P = 0.003) compared to control/placebo from baseline.
    The SGLT2 inhibitors treatment offers an effective strategy for improving NT-proBNP levels, Kansas City Cardiomyopathy Questionnaire scores and 6-minute walk distance in CHF with or without T2DM. These findings indicate that SGLT2i improve cardiac function and health status in CHF with or without T2DM, and provide valuable guidance for clinicians making treatment decisions for patients with CHF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号