Microvascular dysfunction in patients with heart failure with preserved ejection fraction: A meta-analysis

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2023-07-25 DOI:10.1111/micc.12822

Mai Azuma, Shingo Kato, Kazuki Fukui, Nobuyuki Horita, Daisuke Utsunomiya

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引用次数: 1

Abstract

Background

Although microvascular dysfunction (MVD) is considered an essential pathophysiology in patients with heart failure with preserved ejection fraction (HFpEF), the frequency and prognostic impact of MVD are not fully understood. This meta-analysis evaluated the frequency of MVD in patients with HFpEF and its utility in risk stratification.

Materials and Methods

On May 26, 2022, a literature search was performed on PubMed, Web of Science, the Cochrane library, and Embase using the search terms such as “Heart failure with preserved ejection fraction,” “HFpEF,” “microvascular dysfunction,” and “MVD.” The prevalence of MVD in patients with HFpEF was calculated using the general inverse variance method. A comprehensive literature review was conducted to examine the association between MVD and prognosis in patients with HFpEF.

Results

Data pertaining to a total of 941 patients diagnosed with HFpEF were extracted from the collective pool of 9 studies. The results of the meta-analysis revealed that the frequency of MVD among patients with HFpEF was found to be 55.5% (95% CI: 34.8%–76.2%), with a substantial degree of heterogeneity (I² = 98%, p for heterogeneity <.001). Among the five studies that provided data on the association between MVD and prognosis, a significant statistical association was observed in four of them.

Conclusions

This meta-analysis revealed that approximately 50% of patients diagnosed with HFpEF exhibited MVD. Moreover, the presence of MVD demonstrated significant prognostic implications in multiple studies conducted on patients with HFpEF. These findings strongly suggest that MVD plays a crucial role in the underlying pathophysiology of patients with HFpEF.

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射血分数保留的心力衰竭患者的微血管功能障碍：一项荟萃分析。

背景：尽管微血管功能障碍（MVD）被认为是射血分数保留（HFpEF）的心力衰竭患者的一种重要病理生理学，但MVD的频率和预后影响尚不完全清楚。这项荟萃分析评估了HFpEF患者MVD的频率及其在风险分层中的作用。材料和方法：2022年5月26日，在PubMed、Web of Science、Cochrane图书馆和Embase上使用“射血分数保留的心力衰竭”、“HFpEF”、“微血管功能障碍”和“MVD”等搜索词进行文献检索。使用通用逆方差法计算HFpEF患者的MVD患病率。对HFpEF患者的MVD与预后之间的关系进行了全面的文献综述。结果：从9项研究的集合中提取了941名诊断为HFpEF的患者的相关数据。荟萃分析结果显示，HFpEF患者的MVD发生率为55.5%（95%CI:34.8%-76.2%），具有显著的异质性（I2 = 98%，异质性为p结论：该荟萃分析显示，约50%的HFpEF患者表现出MVD。此外，在对HFpEF患者进行的多项研究中，MVD的存在显示出显著的预后影响。这些发现有力地表明，MVD在HFpEF患者的潜在病理生理学中起着至关重要的作用。

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

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.