慢性查加斯心肌病患者的基于运动的训练计划:系统性审查和元分析
Pablo M Calderon-Ramirez1, Daniel Fernandez-Guzman2, Brenda Caira-Chuquineyra1
1Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru.
International journal of cardiology. Heart & vasculature
|October 5, 2023
概括
基于运动的训练计划 (EBTP) 在慢性查加斯心肌病 (CCC) 患者中显著改善了运动能力. 然而,需要更多的研究来证实对死亡率和其他结果的影响.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 公共卫生 公共卫生
背景情况:
- 慢性查加斯心肌病 (CCC) 是一个重大的健康问题,特别是在低收入和中等收入国家.
- 目前对CCC的治疗选择可能有限,需要探索辅助疗法.
- 基于运动的训练计划 (EBTP) 越来越多地被认为在各种慢性疾病中具有潜在的益处.
研究的目的:
- 系统地审查和元分析EBTP在被诊断为CCC的患者的影响.
- 评估EBTP对CCC患者死亡率,生活质量,运动能力和心脏功能的影响.
- 发现CCC的EBTP证据中的差距,并指导未来的研究.
主要方法:
- 在多个数据库 (PubMed,Embase,Scopus,Web of Science,Cochrane Library,VHL,SciELO) 进行了全面的文献搜索,截至2023年1月.
- 包括的研究包括随机对照试验 (RCT) 和非随机干预研究 (NRIS),涉及接受EBTP的CCC患者.
- 评估的主要结局是全因死亡率,心血管死亡率和与健康相关的生活质量 (HRQoL);二级结局包括VO2峰值,与心力衰竭相关的住院病例 (HFRHA) 和左心室喷射率 (LVEF).
主要成果:
- 包括8项研究 (3项RCT,5项NRIS) 涉及222名CCC患者,主要来自巴西.
- 在包括的研究中,关于死亡率,HRQoL,LVEF和HFRHA的数据很少被报告.
- 对四项研究的元分析显示,EBTP组与对照组相比,EBTP组的峰值VO2 (平均差异为4.45mL/kg/min) 显著改善 (I2=0%).
结论:
- 基于有限的证据,EBTP在改善CCC患者的运动能力和潜在的HRQoL方面表现有前途.
- 目前缺乏关于EBTP对CCC死亡率和其他硬结局的影响的确证据.
- 进一步进行高质量的研究对于确定EBTP在治疗慢性查加斯心肌病的有效性和安全性至关重要,特别是在资源有限的环境中.
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