The Effects of Aerobic Exercise on N-terminal Pro-B-type Natriuretic Peptide and Cardiopulmonary Function in Patients With Heart Failure: A Meta-Analysis of Randomised Clinical Trials

2020 ◽  
Vol 29 (12) ◽  
pp. 1790-1798
Author(s):  
Anwar Santoso ◽  
Rido Maulana ◽  
Fatimah Alzahra ◽  
Hawani Sasmaya Prameswari ◽  
Ade Meidian Ambari ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trials ◽  
Aerobic Exercise ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Randomised Clinical Trials ◽  
Cardiopulmonary Function ◽  
Patients With Heart Failure

scholarly journals The effects of adding angiotensin receptor neprilysin inhibitors to usual care in patients with heart failure: a protocol for a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Emil Eik Nielsen ◽  
Joshua Feinberg ◽  
Ilan Raymond ◽  
Michael Hecht Olsen ◽  
Frank Victor Steensgaard-Hansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Trials ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Randomised Clinical Trials ◽  
Trial Sequential Analysis ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Patients With Heart Failure

Abstract Background Heart failure is a highly prevalent disease with a global prevalence of 37 million, and the prevalence is increasing. Patients with heart failure are at an increased risk of death and morbidity. Traditionally, patients with heart failure have been treated with a beta-blocker in addition to an inhibitor of the renin-angiotensin-aldosterone system. However, new drugs are currently being added to the recommended guideline therapy. The latest drug to be added combines inhibition of the renin-angiotensin-aldosterone system pathway with inhibiting the neprilysin enzyme and is therefore classified as an ARNI. Our objective is to identify the beneficial and harmful effects of ARNIs in the treatment of patient with heart failure. Methods This protocol for a systematic review was undertaken using the recommendations of the Cochrane, the Preferred Report Items of Systematic reviews with Meta-Analysis Protocols, and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the use of ARNIs in the treatment of patients with heart failure. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP), and BIOSIS to identify relevant trials. We will also search for grey literature and unpublished trials. Extracted data will be analysed using Review Manager 5, STATA 5, and Trial Sequential Analysis. Our primary outcomes will be all-cause mortality and serious adverse events. We will create a ‘Summary of Findings’ table in which we will present our primary and secondary outcomes, and we will assess the quality of evidence using the GRADE assessment. Discussion The present systematic review will have the potential to aid clinicians in decision-making and thereby, benefit patients with heart failure. Systematic review registration PROSPERO CRD42019129336

scholarly journals Essential components in natriuretic peptide-guided management of heart failure: an intervention synthesis

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000826 ◽  
Author(s):  
Jason Oke ◽  
Alison Clements ◽  
Julie McLellan ◽  
Clare Bankhead ◽  
Clare J Taylor ◽  
...  
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Treatment Protocol ◽  
Credible Interval ◽  
Treatment Interventions ◽  
Policy Makers ◽  
Essential Components ◽  
Patients With Heart Failure ◽  
Regression Techniques

AimTo identify the key components of natriuretic peptide (NP)-guided treatment interventions which reduced hospitalisation in patients with heart failure (HF).Methods and resultsWe extracted detailed information on the components of interventions from studies of NP-guided treatment of HF identified in a previous systematic review. We used meta-regression techniques to assess univariate associations between components and the strength of the reduction in HF hospitalisations and all-cause mortality. A Bayesian meta-analysis approach was used to re-estimate study-level effects in order to identify the study with the most effective NP-guided monitoring intervention. Finally, we examined the intervention options common to the studies in which the 95% credible interval excluded no effect. We identified eight components of NP-guided treatment from ten studies. Univariate comparisons produced mainly equivocal results, but single trial choice and common components analysis led to similar conclusions. Using a predefined treatment protocol, setting a stringent NP target (N-terminal pro-B-type natriuretic peptide of 1000 pg/mL or B-type natriuretic peptide 100 pg/mL) and including a relative targetwere potential key components to reducing HF hospitalisations using NP-guided therapy.ConclusionThis analysis provides a description of the key components of NP-guided treatment which could help policy makers develop specific recommendations for HF management. Our research suggests that NP-guided interventions could be simplified, but more research in relevant health settings, such as primary care, is required.

scholarly journals Aerobic Training Intensity for Improved Endothelial Function in Heart Failure Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
M. J. Pearson ◽  
N. A. Smart
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Endothelial Function ◽  
Aerobic Exercise ◽  
Aerobic Training ◽  
Meta Analysis ◽  
Flow Mediated Dilation ◽  
Training Intensity ◽  
Heart Failure Patients ◽  
Patients With Heart Failure

Objective. Flow-mediated dilation (FMD) is widely utilised to assess endothelial function and aerobic exercise improves FMD in heart failure patients. The aim of this meta-analysis is to quantify the effect of aerobic training intensity on FMD in patients with heart failure. Background. A large number of studies now exist that examine endothelial function in patients with heart failure. We sought to add to the current literature by quantifying the effect of the aerobic training intensity on endothelial function. Methods. We conducted database searches (PubMed, Embase, ProQuest, and Cochrane Trials Register to June 30, 2016) for exercise based rehabilitation trials in heart failure, using search terms exercise training, endothelial function, and flow-mediated dilation (FMD). Results. The 13 included studies provided a total of 458 participants, 264 in intervention groups, and 194 in nonexercising control groups. Both vigorous and moderate intensity aerobic training significantly improved FMD. Conclusion. Overall both vigorous and moderate aerobic exercise training improved FMD in patients with heart failure.

scholarly journals Inspiratory Muscle Training in Patients with Heart Failure

2020 ◽  
Vol 9 (6) ◽  
pp. 1710
Author(s):  
Hugo Fernandez-Rubio ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
David Rodríguez-Sanz ◽  
César Calvo-Lobo ◽  
Davinia Vicente-Campos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Trials ◽  
Exercise Training ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Inspiratory Muscle ◽  
Muscle Training ◽  
Patients With Heart Failure

Background: Prior systematic reviews and meta-analysis addressed that inspiratory muscle training (IMT) improved inspiratory muscle weakness, cardiorespiratory fitness and quality of life similar to conventional exercise training as a first alternative in deconditioned patients with heart failure (HF) lead to a better adaptation to posterior exercise training. The heterogeneity and variability in a wide range of new studies about this topic led to the necessity of an updated and comprehensive narrative review. The present review aimed to analyze and update the most relevant studies about IMT in patients who suffer from HF. Methods: A narrative review was carried out about IMT in HF patients including 26 experimental studies divided into 21 clinical trials and 5 quasi-experimental studies identified through database searching in PubMed, Cochrane and PEDro. Results: There is enough evidence to state that IMT produces improvements in functional capacity of patients with HF. Nevertheless, there is not enough evidence to support that IMT could improve cardiovascular parameters, blood biomarkers or quality of life in these patients. Conclusions: Thus, IMT may be recommended to improve functional capacity in patients who suffer from HF; nevertheless, more evidence is needed regarding cardiovascular parameters, biomarkers and quality of life. Furthermore, mortality or HF hospitalization was not evaluated and most studies were not longer than 3 months. According to IMT protocols and study designs heterogeneity and mid-term follow-up, further investigations through high-quality long-term randomized clinical trials should be performed to achieve systematic reviews and meta-analysis to support strong evidence for IMT in HF patients.

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