Autonomic regulation device therapy in heart failure with reduced ejection fraction: a systematic review and meta-analysis of randomized controlled trials.
Heart failure with reduced ejection fraction (HFrEF) represents a significant public health burden associated with incremental health care costs. Given the limitations associated with pharmacological autonomic regulation therapy (ART), device-based autonomic neuromodulation is on the horizon now for...
| Publicado en: | Heart Failure Reviews Vol. 24; no. 2; pp. 245 - 255 |
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| Autores principales: | , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Mar2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134870918&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 134870918 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13824147 OG1 jtl: Heart Failure Reviews issn: 13824147 maglogo: N pubinfo: dt: Mar2019 vid: 24 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 134870918 134870918 NLM30317416 134870918 10.1007/s10741-018-9745-5 NLM30317416 134870918 ppf: 245 ppct: 10 formats: tig: atl: Autonomic regulation device therapy in heart failure with reduced ejection fraction: a systematic review and meta-analysis of randomized controlled trials. aug: au: Bendary, Ahmed Bendary, Mohamed Salem, Mohamed affil: Cardiology Department, Benha Faculty of Medicine, Benha University, 13518, Benha, Egypt sug: subj: Heart Failure Physiopathology Vagal Stimulation Equipment and Supplies Autonomic Nervous System Physiopathology Heart Failure Therapy Human Heart Failure Economics Quality of Life Natriuretic Peptide, Brain Blood Treatment Outcomes Male Adult Ventricular Function, Left Physiology Clinical Trials Middle Age Peptides Blood Stroke Volume Physiology Aged Health Care Costs Statistics and Numerical Data Female Meta Analysis Questionnaires Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Heart failure with reduced ejection fraction (HFrEF) represents a significant public health burden associated with incremental health care costs. Given the limitations associated with pharmacological autonomic regulation therapy (ART), device-based autonomic neuromodulation is on the horizon now for ART in those patients. This systematic review aimed primarily to determine the effect of ART by devices on functional status and quality of life (QOL) in patients with HFrEF. We performed a meta-analysis of five randomized controlled trials (1074 patients) comparing ART by devices versus optimal medical therapy (OMT) in HFrEF. We assessed pooled estimates of odds ratio (OR) for improvement in New York Heart Association (NYHA) class and mean differences (MD) in 6-minute hall walk distance (6-MHWD), Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, N-terminal pro b-type natriuretic peptide (NT-proBNP) levels, and left ventricular end-systolic volume index (LVESVi) with their 95% confidence intervals (CIs) at 6-month follow-up. Compared to OMT alone, ART by devices in HFrEF significantly improves NYHA class (OR 2.26, 95% CI 1.33 to 3.83, P = 0.003), increases 6-MHWD (MD 45.53 m, 95% CI 30.61 to 60.45, P < 0.00001), improves MLHFQ score (MD - 10.59, 95% CI - 20.62 to - 0.57, P = 0.04) with neutral effect on NT-proBNP levels (MD - 236.5 pg/ml, 95% CI - 523.86 to 50.87, P = 0.11) and LVESVi (MD - 1.01 ml/m2, 95% CI - 4.49 to 2.47, P = 0.57). We concluded that device-based neuromodulation therapy significantly improves functional status and quality of life in patients with HFrEF. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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