Systolic and diastolic functional reserve of the subpulmonary and systemic right ventricles as assessed by pharmacologic and exercise stress: A systematic review

Introduction: Up to one-third of patients who received resynchronization devices do not experience full benefit of cardiac resynchronization therapy (CRT). Echocardiography plays an important role in heart failure patients treated with CRT. Contractile reserved is a strong prognostic factor to predict positive response to CRT (CRT responder). Objective: We perform a systematic review and meta-analysis of published data to assess the relationship between contractile reserve (CR) and response to CRT. Methods: We conduct a systematic search from major medical databases on all clinical trials published up to June 2020, written in English, full-text availability, and human subject. We used Newcastle-Ottawa Scale to measure the quality of evidence. We employed the Mantel–Haenszel random-effects meta-analysis of using RevMan 5.4. Results: We identified 17 studies involving 1399 patients. The type of stress was either dobutamine (n=15) or exercise (n=2). The presence of CR was associated with a higher chance of CRT responder (OR 7.68, 95%CI 4.27–13.82, p<0.001) using a random-effects model. The ORs slightly differed when studies were analyzed separately based on the stress test type and definition of CR. Contractile reserve, assessed with dobutamine stress echocardiography (DSE), defined as an increase in LVEF (OR 5.10, 95% CI 2.29–11.32, P <0.00001) was numerically lower than defined as increased LV contractility (OR 6.86, 95% CI 3.36–12.88, P <0.00001). The presence of CR assessed with exercise stress test are associated with higher chance of CRT responder (OR 49.11, 95% CI 15.04–160.36, P <0.00001). From our meta-analysis, we found non-ischemic has better respond to CRT compare to patient with ischemic etiology (OR 0.41; 95% CI 0.31-0.55, P <0.01). Conclusion: The presence of CR during stress test echocardiography with either dobutamine or exercise stress test is associated with a higher chance of CRT responder.

Download Full-text

Systematic Review Of The Effects Of Glycerol Hyperhydration On Endurance Performance During Compensable Exercise Stress

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-200505001-00218 ◽

2005 ◽

Vol 37 (Supplement) ◽

pp. S40???S41

Author(s):

Eric D. Goulet ◽

Rick L. Sharp ◽

G??rard E. Plante ◽

Michel O. M??lan??on ◽

Isabelle J. Dionne

Keyword(s):

Systematic Review ◽

Endurance Performance ◽

Exercise Stress

Download Full-text

Effectiveness of Workplace-Based Diet and Lifestyle Interventions on Risk Factors in Workers with Metabolic Syndrome: A Systematic Review, Meta-Analysis and Meta-Regression

Nutrients ◽

10.3390/nu13124560 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4560

Author(s):

Alicia Gea Cabrera ◽

Pablo Caballero ◽

Carmina Wanden-Berghe ◽

María Sanz-Lorente ◽

Elsa López-Pintor

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Effect Size ◽

Pressure Effect ◽

Meta Analysis ◽

Exercise Stress ◽

Dietary Interventions ◽

Blood Pressure Effect ◽

Meta Regression

Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.

Download Full-text

A Systematic Review of Renal Functional Reserve in Adult Living Kidney Donors

Kidney International Reports ◽

10.1016/j.ekir.2019.12.021 ◽

2020 ◽

Vol 5 (4) ◽

pp. 448-458 ◽

Cited By ~ 1

Author(s):

Andreja Figurek ◽

Valerie A. Luyckx ◽

Thomas F. Mueller

Keyword(s):

Systematic Review ◽

Functional Reserve ◽

Kidney Donors ◽

Living Kidney Donors ◽

Renal Functional Reserve

Download Full-text

Abstract 13566: Clinical Utility of Noninvasive Assessment of Flow-pressure Relationship in Scleroderma

Circulation ◽

10.1161/circ.142.suppl_3.13566 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Miharu Arase ◽

Kenya Kusunose ◽

sae morita ◽

Natsumi Yamaguchi ◽

Yukina Hirata ◽

...

Keyword(s):

Vascular Function ◽

Early Stage ◽

Stress Test ◽

Exercise Stress Test ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

High Risk Group ◽

Exercise Stress ◽

Lv Function ◽

Functional Reserve

Introduction: Cardiac involvement in Systemic sclerosis (SSc), especially left ventricular diastolic dysfunction (DD), is high prevalence and associated with high mortality. Thus, the early detection of left ventricular DD might be important to manage SSc. Recent study has shown that exercise stress test may evaluate an early stage of heart failure in patients with normal resting echocardiogram. Hypothesis: We hypothesized that SSc patients with normal resting hemodynamics may present early phase of left ventricular DD by exercise echocardiogram, leading to the model of predicting long-term outcomes. Methods: Between January 2014 and December 2018, we prospectively enrolled 140 SSc patients who underwent 6-minute walk (6MW) stress echocardiographic studies with normal range of estimated mean pulmonary arterial pressure (mPAP) (<25mmHg) and mean pulmonary artery wedge pressure (mPAWP) (<15mmHg) at rest. We used ΔmPAP/Δcardiac output (CO) to assess pulmonary vascular reserve and ΔmPAWP/ΔCO to assess left ventricular (LV) reserve between resting and post-6MW point. Results: During a median period of 3.6 years, 25 patients (18%) reached the composite outcome. Both ΔmPAP/ΔCO and ΔmPAWP/ΔCO in patients with events were significantly higher than in ones without events (8.9±3.8mmHg/l/min vs. 3.0±1.7mmHg/l/min; p=0.002, and 2.2±0.9mmHg/l/min vs. 0.9±0.5mmHg/l/min; p<0.001, respectively). In addition, ΔmPAWP/ΔCO is strongly associated with events (p=0.04) in patients with normal ΔmPAP/ΔCO (≤median value), although ΔmPAWP/ΔCO had weak impact in patients with abnormal ΔmPAP/ΔCO (>median value) (p=0.23). Conclusions: Exercise echocardiography revealed impaired LV functional reserve in SSc patients with normal resting hemodynamics. Furthermore, in the group of normal pulmonary vascular function, the patients with impaired LV functional reserve had significantly shorter event-free survival than the ones with non-impaired LV function. Thus, the evaluation of early left ventricular DD with 6MW may detect high-risk group in SSc patients.

Download Full-text