心力衰竭患者肺动脉高压患病率:系统回顾和荟萃分析

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Maaedah Khan, Rhea Suribhatla, Jak Spencer, Nadia Daniel, Alex Pitcher, Christiana Kartsonaki
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引用次数: 0

摘要

目的心力衰竭(HF)是世界范围内住院治疗的主要原因。心衰可导致肺动脉高压(PH),同时出现心衰和PH与预后不良相关。本系统综述和荟萃分析旨在估计心衰患者中PH的患病率。方法:我们检索MEDLINE和EMBASE中关于HF患者中PH患病率的研究。采用随机效应模型对PH患病率进行meta分析,包括亚组分析。根据合并症和患者特征进行亚组分析和meta回归。使用乔安娜布里格斯研究所关键评估工具评估研究质量。结果纳入54篇论文,共259 665例HF患者,其中46 004例同时患有PH。HF患者的总体PH患病率估计为46.6% (95% CI: 39.6%-53.7%)。不同诊断方法的患病率不同,使用右心导管的研究报告的患病率最高(62.5%;52.0%-72.0%),医院记录的数据最低(18.4%;14.4%-23.3%),超声心动图的患病率为45.7%(37.1%-54.6%)。保留心力衰竭的患病率(47.2%;34.8% ~ 60.0%)高于射血分数降低的患病率(35.7%;22.6% ~ 51.3%)。前瞻性研究的估计值(60.1%;50.7%-68.8%)高于回顾性研究(37.3%;29.5%-45.9%)。这是第一个系统回顾和荟萃分析,调查了HF患者中PH的患病率,并表明该患者人群中PH的患病率非常高。不同研究报告的估计值存在显著差异,这主要归因于ph诊断方法的差异。未来需要采用可靠的标准化方法进行研究,以更准确地估计患病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prevalence of Pulmonary Hypertension in Individuals With Heart Failure: A Systematic Review and Meta-Analysis

Prevalence of Pulmonary Hypertension in Individuals With Heart Failure: A Systematic Review and Meta-Analysis

Aims

Heart failure (HF) is a leading cause of hospitalizations worldwide. HF can lead to pulmonary hypertension (PH) and co-occurrence of HF and PH is associated with a poor prognosis. This systematic review and meta-analysis aim to estimate the prevalence of PH in patients with HF.

Methods

We searched MEDLINE and EMBASE for studies reporting the prevalence of PH amongst HF patients. A meta-analysis of PH prevalence, including subgroup analyses, was conducted using a random-effects model. Subgroup analyses and meta-regressions by comorbidities and patient characteristics were done. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool.

Results

Fifty-four papers with 259 665 HF patients were included, of which 46 004 also had PH. The overall PH prevalence estimate in individuals with HF is 46.6% (95% CI: 39.6%–53.7%). Prevalence varied by diagnostic method, with studies using right heart catheterization reporting the highest estimates (62.5%; 52.0%–72.0%), hospital recorded data the lowest (18.4%; 14.4%–23.3%), and echocardiography 45.7% (37.1%–54.6%). Prevalence was higher in HF with preserved (47.2%; 34.8%–60.0%) than reduced ejection fraction (35.7%; 22.6%–51.3%). Prospective studies show higher estimates (60.1%; 50.7%–68.8%) than retrospective studies (37.3%; 29.5%–45.9%).

Conclusions

This is the first systematic review and meta-analysis investigating the prevalence of PH in HF patients and shows that the prevalence of PH in this patient population is strikingly high. There is notable variability in estimates reported by different studies, largely attributed to differences in the diagnostic method of PH. Future studies with robust, standardized methodologies are needed to estimate prevalence more accurately.

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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
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.
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