{"title":"心脏瓣膜手术后以运动为基础的心脏康复:循证图谱研究的系统回顾和再评价","authors":"Rongxiang Zhang, Chenyang Zhu, Shiqi Chen, Feng Tian, Yuan Chen","doi":"10.1002/clc.70117","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>This systematic review and evidence mapping study aims to assess the effects of exercise-based cardiac rehabilitation on clinical outcomes in patients after heart valve surgery. By consolidating and visualizing existing evidence, the study seeks to identify gaps in knowledge, evaluate the quality and breadth of current research, and provide guidance for clinical practice and future research. The evidence mapping will highlight under-researched areas and inform healthcare providers on effective strategies to enhance postoperative recovery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A comprehensive search was performed across multiple databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, CNKI, and Wanfang, up to May 2024. Two reviewers independently screened the articles, extracted relevant data, and assessed study quality. Study characteristics and outcomes were visualized using bubble plots.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Ten systematic reviews/meta-analyses met the inclusion criteria. Based on AMSTAR-2, two were rated “high quality,” two “low quality,” and six “very low quality.” Using the GRADE system, of the 48 pieces of evidence across 10 outcomes, 1 was “high quality,” 8 “moderate,” 19 “low,” and 20 “very low.”</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Current evidence indicates that exercise-based cardiac rehabilitation can enhance physical capacity, left ventricular ejection fraction, peak oxygen uptake, and daily living activities in heart valve surgery patients. However, more large-scale, high-quality studies are needed to verify its effects on all-cause mortality, quality of life, adverse events, return to work, and emotional health.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70117","citationCount":"0","resultStr":"{\"title\":\"Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping Study\",\"authors\":\"Rongxiang Zhang, Chenyang Zhu, Shiqi Chen, Feng Tian, Yuan Chen\",\"doi\":\"10.1002/clc.70117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This systematic review and evidence mapping study aims to assess the effects of exercise-based cardiac rehabilitation on clinical outcomes in patients after heart valve surgery. 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引用次数: 0
摘要
目的本系统综述和证据图谱研究旨在评估心脏运动康复对心脏瓣膜术后患者临床预后的影响。通过巩固和可视化现有证据,该研究旨在确定知识差距,评估当前研究的质量和广度,并为临床实践和未来研究提供指导。证据地图将突出研究不足的领域,并告知医疗保健提供者有效的策略,以提高术后恢复。方法对截至2024年5月的PubMed、Embase、Cochrane CENTRAL、Web of Science、CNKI、万方等多个数据库进行综合检索。两位审稿人独立筛选文章,提取相关数据,并评估研究质量。用气泡图显示研究特征和结果。结果10项系统评价/meta分析符合纳入标准。根据AMSTAR-2, 2个被评为“高质量”,2个被评为“低质量”,6个被评为“非常低质量”。使用GRADE系统,在10个结局的48个证据中,1个为“高质量”,8个为“中等”,19个为“低质量”,20个为“非常低”。结论基于运动的心脏康复可以提高心脏瓣膜手术患者的体能、左心室射血分数、峰值摄氧量和日常生活能力。然而,需要更大规模、高质量的研究来验证其对全因死亡率、生活质量、不良事件、重返工作岗位和情绪健康的影响。
Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping Study
Objective
This systematic review and evidence mapping study aims to assess the effects of exercise-based cardiac rehabilitation on clinical outcomes in patients after heart valve surgery. By consolidating and visualizing existing evidence, the study seeks to identify gaps in knowledge, evaluate the quality and breadth of current research, and provide guidance for clinical practice and future research. The evidence mapping will highlight under-researched areas and inform healthcare providers on effective strategies to enhance postoperative recovery.
Methods
A comprehensive search was performed across multiple databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, CNKI, and Wanfang, up to May 2024. Two reviewers independently screened the articles, extracted relevant data, and assessed study quality. Study characteristics and outcomes were visualized using bubble plots.
Results
Ten systematic reviews/meta-analyses met the inclusion criteria. Based on AMSTAR-2, two were rated “high quality,” two “low quality,” and six “very low quality.” Using the GRADE system, of the 48 pieces of evidence across 10 outcomes, 1 was “high quality,” 8 “moderate,” 19 “low,” and 20 “very low.”
Conclusion
Current evidence indicates that exercise-based cardiac rehabilitation can enhance physical capacity, left ventricular ejection fraction, peak oxygen uptake, and daily living activities in heart valve surgery patients. However, more large-scale, high-quality studies are needed to verify its effects on all-cause mortality, quality of life, adverse events, return to work, and emotional health.
期刊介绍:
Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery.
The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content.
The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.