Influence of enhanced external counterpulsation on endothelial function: a meta-analysis of randomized controlled trials.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2023-12-01 Epub Date: 2023-10-24 DOI:10.1080/14017431.2023.2273223
Qiulin Yin, Hua Jiang, Zhifeng Zhang, Long Zhang, Zhiyong Wu, Li Huang, Xuanlan Chen
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引用次数: 0

Abstract

Objectives: Enhanced external counterpulsation (EECP) is an effective and noninvasive treatment for patients with refractory angina and chronic heart failure. However, previous studies evaluating the influence of EECP on endothelial function showed inconsistent results. This systematic review and meta-analysis was conducted to evaluate the effects of EECP on endothelial function measured by brachial artery flow-mediated dilation (FMD).

Design: PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases were searched for randomized controlled trials comparing the influence of EECP versus usual care on FMD in adult population. A random-effects model incorporating the potential influence of heterogeneity was used to pool the results.

Results: Nineteen studies with 1647 patients were included in the meta-analysis. Compared with usual care or conventional therapy, additional treatment with EECP for 3-7 weeks was associated with a significantly improved FMD (mean difference [MD]: 1.96%, 95% confidence interval [CI]: 1.57-2.36, p < 0.001, I2 = 52%). Subgroup analysis showed consistent results in patients with coronary artery disease and in patients with other diseases (p for subgroup difference = 0.21). Results of meta-regression analysis showed that the mean baseline FMD level was positively correlated with the influence of EECP on FMD (coefficient = 0.42, p < 0.001). Results of subgroup analysis suggested that the increment of FMD following EECP was larger in patients with baseline FMD ≥ 5% (MD: 2.69, 95% CI: 2.27-3.10, p < 0.001; I2 = 15%) compared to those with baseline FMD < 5% (MD: 1.49, 95% CI: 1.13-1.85, p < 0.001; I2 = 0%; p for subgroup difference < 0.001).

Conclusions: EECP may be effective in improving endothelial function measured by FMD.

增强外部反搏对内皮功能的影响:随机对照试验的荟萃分析。
目的:增强型体外反搏(EECP)是治疗难治性心绞痛和慢性心力衰竭的有效且无创的方法。然而,先前评估EECP对内皮功能影响的研究显示出不一致的结果。本系统综述和荟萃分析旨在评估通过肱动脉血流介导舒张(FMD)测量的EECP对内皮功能的影响。设计:检索PubMed、Embase、Cochrane Library、CNKI和Wanfang数据库,进行随机对照试验,比较EECP与常规护理对成年人群FMD的影响。采用包含异质性潜在影响的随机效应模型对结果进行汇总。结果:荟萃分析包括19项研究,涉及1647名患者。与常规护理或常规治疗相比,EECP的额外治疗3-7 周与FMD显著改善相关(平均差异[MD]:1.96%,95%置信区间[CI]:1.57-2.36,p I2=52%)。亚组分析显示,冠状动脉疾病患者和其他疾病患者的结果一致(亚组差异p=0.21)。元回归分析结果显示,平均基线FMD水平与EECP对FMD的影响呈正相关(系数=0.42,p MD:2.69,95%置信区间:2.27-3.10,p I2=15%)与基线FMD<5%的患者相比(MD:1.49,95%CI:1.13-1.85,p I2=0%;p亚组差异<0.001)。结论:EECP可有效改善FMD测定的内皮功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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