心脏瓣膜病(VHD)是一种心脏瓣膜结构和/或功能异常的心血管疾病,是全球心血管疾病发病率和死亡率快速增长的原因。缺乏体力活动是VHD患者的问题,尤其是手术后.然而,大型多中心随机对照试验(RCTs)没有关于运动对VHD影响的数据.因此,我们进行了系统综述和荟萃分析,对小型随机对照试验进行了综合分析,以评估运动对VHD患者心肺功能的影响,为制定和指导运动在VHD患者中的临床应用提供循证医学依据.
■我们对随机对照试验进行了系统评价和荟萃分析。我们系统地搜索了电子数据库(PubMed,WebofScience,Embase,Cochrane中央控制试验登记册,中国国家知识基础设施[CNKI],中国科技期刊数据库[VIP],万方数据库,和SinoMed[CBM])从开始到2023年1月的所有关于运动和VHD的研究。使用Cochrane偏倚风险工具评估纳入研究的质量。主要结果是六分钟步行测试距离(6MWD),左心室射血分数(LVEF),和简短的36项健康调查(SF-36)。
■这项系统评价包括22项RCT,1520名受试者(869名男性和651名女性)。荟萃分析结果表明,运动显著提高了6MWD测量的运动能力(均差[MD]=25.54,95%置信区间[CI]=19.98-31.11,I2=0%,p<0.00001),LVEF(MD=6.20,95%CI=4.76-7.65,I2=66%,p<0.00001),和通过SF-36测量的生活质量(身体功能:MD=3.42,95%CI=2.12-4.72,I2=12%,p<0.00001;心理健康:MD=3.86,95%CI=0.52-7.20,I2=68%,p=0.020;社会功能:MD=2.30,95%CI=0.64-3.97,I2=45%,p=0.007;身体疼痛:MD=2.60,95%CI=0.83-4.37,I2=22%,与健康对照相比,VHD患者的p=0.004)。
■这项研究表明,运动可以显着改善心肺功能,增强身体和社会功能,减少身体疼痛,并有可能改善VHD患者的心理健康,为VHD患者更好的康复提供循证依据。
UNASSIGNED: Valvular heart disease (VHD) is a type of cardiovascular disease with abnormal heart valve structure and/or function and a rapidly growing cause of global cardiovascular morbidity and mortality. Physical inactivity is a problem for patients with VHD, especially after surgery. However, there is no data on the effects of exercise on VHD from large multicentre randomised controlled trials (RCTs). Therefore, we conducted a systematic review and meta-analysis to provide a comprehensive analysis of small RCTs to evaluate the effects of exercise on cardiopulmonary function in patients with VHD and provide an evidence-based medicine basis for developing and guiding the clinical application of exercise in patients with VHD.
UNASSIGNED: We conducted a systematic review and meta-analysis of RCTs. We systematically searched electronic databases (PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure [CNKI], China Science and Technology Journal Database [VIP], WanFang Database, and SinoMed [CBM]) for all studies on exercise and VHD from their inception to January 2023. The quality of included studies was assessed using the Cochrane risk-of-bias tool. The primary outcomes were the six-minute walk test distance (6MWD), left ventricular ejection fraction (LVEF), and short-form 36-item health survey (SF-36).
UNASSIGNED: This systematic review included 22 RCTs with 1520 subjects (869 men and 651 women). The meta-analysis results showed that exercise significantly improved exercise capacity measured by the 6MWD (mean difference [MD] = 25.54, 95% confidence interval [CI] = 19.98-31.11, I 2 = 0%, p < 0.00001), LVEF (MD = 6.20, 95% CI = 4.76-7.65, I 2 = 66%, p < 0.00001), and quality of life measured by the SF-36 (physical function: MD = 3.42, 95% CI = 2.12-4.72, I 2 = 12%, p < 0.00001; mental health: MD = 3.86, 95% CI = 0.52-7.20, I 2 = 68%, p = 0.020; social function: MD = 2.30, 95% CI = 0.64-3.97, I 2 = 45%, p = 0.007; bodily pain: MD = 2.60, 95% CI = 0.83-4.37, I 2 = 22%, p = 0.004) in patients with VHD compared to healthy controls.
UNASSIGNED: This study suggests that exercise can significantly improve cardiopulmonary function, enhance physical and social function, reduce bodily pain, and potentially improve mental health in patients with VHD, providing an evidence-based basis for better recovery in patients with VHD.