Qiulin Yin, Hua Jiang, Zhifeng Zhang, Long Zhang, Zhiyong Wu, Li Huang, Xuanlan Chen
{"title":"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。","authors":"Qiulin Yin, Hua Jiang, Zhifeng Zhang, Long Zhang, Zhiyong Wu, Li Huang, Xuanlan Chen","doi":"10.1080/14017431.2023.2273223","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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 [<i>MD</i>]: 1.96%, 95% confidence interval [CI]: 1.57-2.36, <i>p</i> < 0.001, <i>I</i><sup>2</sup> = 52%). Subgroup analysis showed consistent results in patients with coronary artery disease and in patients with other diseases (<i>p</i> 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, <i>p</i> < 0.001). Results of subgroup analysis suggested that the increment of FMD following EECP was larger in patients with baseline FMD ≥ 5% (<i>MD</i>: 2.69, 95% CI: 2.27-3.10, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 15%) compared to those with baseline FMD < 5% (<i>MD</i>: 1.49, 95% CI: 1.13-1.85, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 0%; <i>p</i> for subgroup difference < 0.001).</p><p><strong>Conclusions: </strong>EECP may be effective in improving endothelial function measured by FMD.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of enhanced external counterpulsation on endothelial function: a meta-analysis of randomized controlled trials.\",\"authors\":\"Qiulin Yin, Hua Jiang, Zhifeng Zhang, Long Zhang, Zhiyong Wu, Li Huang, Xuanlan Chen\",\"doi\":\"10.1080/14017431.2023.2273223\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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 [<i>MD</i>]: 1.96%, 95% confidence interval [CI]: 1.57-2.36, <i>p</i> < 0.001, <i>I</i><sup>2</sup> = 52%). Subgroup analysis showed consistent results in patients with coronary artery disease and in patients with other diseases (<i>p</i> 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, <i>p</i> < 0.001). Results of subgroup analysis suggested that the increment of FMD following EECP was larger in patients with baseline FMD ≥ 5% (<i>MD</i>: 2.69, 95% CI: 2.27-3.10, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 15%) compared to those with baseline FMD < 5% (<i>MD</i>: 1.49, 95% CI: 1.13-1.85, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 0%; <i>p</i> for subgroup difference < 0.001).</p><p><strong>Conclusions: </strong>EECP may be effective in improving endothelial function measured by FMD.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14017431.2023.2273223\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14017431.2023.2273223","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
Influence of enhanced external counterpulsation on endothelial function: a meta-analysis of randomized controlled trials.
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.
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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