scholarly journals Efficacy and Safety of Qishen Yiqi Dripping Pill for Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengxi Wang ◽  
Yiwen Shan ◽  
Chenjie Wu ◽  
Peihua Cao ◽  
Weixin Sun ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Efficacy And Safety ◽  
Inflow Velocity ◽  
Mitral Inflow ◽  
Mitral Inflow Velocity

Background: The number of heart failure with preserved ejection fraction (HFpEF) patients is increasing year by year, yet all western medicines currently used for heart failure have been shown to be ineffective for HFpEF. Qishen Yiqi Dripping Pill is one of the commonly drugs for the treatment of heart failure in China. In recent years, some clinical studies found that it has curative effect on HFpEF.Objective: To evaluate the efficacy and safety of Qishen Yiqi Dripping Pill in treatment of HFpEF.Methods: Databases including CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, The Cochrane Library and EMbase were searched from their inception to May 2020 to screen relevant randomized controlled trials. The “risk of bias” evaluation tool in the Cochrane Handbook was used to evaluate the quality of the included studies. RevMan 5.3 software was used for meta-analysis.Results: Eight studies meeting the criteria were included, with a total of 895 patients. The results of meta-analysis showed that compared with western medicine alone, combination of western medicine and Qishen Yiqi Dripping Pill can further increase the quotient of early diastolic mitral inflow velocity and late diastolic mitral inflow velocity (E/A) in patients with HFpEF [mean difference (MD) = 0.20, 95% CI (0.14, 0.26), p < 0.000 01], decrease the quotient of early diastolic mitral inflow velocity and mitral annular tissue velocity (E/e′) [MD = −2.50, 95% CI (−3.18, −1.82), p < 0.000 01], decrease brain natriuretic peptide (BNP) [MD = −151.83, 95% CI (−245.78, −57.89), p = 0.002], increase cardiac function improvement rate [relative risk (RR) = 1.30, 95% CI (1.11, 1.52), p = 0.001], and increase six-minutes walking distance (6-MWD) [MD = 64.75, 95% CI (22.65, 106.85), p = 0.003]. Four studies reported the occurrence of adverse reactions, among which three studies reported no adverse reactions and one study reported three patients with mild adverse reactions in the intervention group.Conclusion: Current evidence suggests that Qishen Yiqi Dripping Pill may be effective in the treatment of HFpEF. However, due to the low quality of the included studies, lack of placebo control, large heterogeneity among different studies, and great possibility of publication bias, the results of our review should be evaluated with more prudence, more high-quality clinical studies are needed to verify the conclusion in the future. In addition, the safety of Qishen Yiqi Dripping Pill remains uncertain, further assessment is required in the future.

scholarly journals The Effect of Exercise Training, IMT and FES on Diastolic Function, Exercise Capacity and Quality of Life in Patients With Heart Failure With Preserved Ejection Fraction: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Chenchen Zhuang ◽  
Xufei Luo ◽  
Qiongying Wang ◽  
Shipeng Li ◽  
Xiaofang Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Endurance Training ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Combined Exercise

Abstract Background: We aimed to better understand the effects of two exercise training interventions [endurance training and a combination of endurance and resistance training (combined exercise)] and two physiotherapies [functional electrical stimulation (FES) and inspiratory muscle training (IMT)] on diastolic function, exercise performance and quality of life (QoL) in heart failure with preserved ejection fraction (HFpEF) patients.Methods: Cochrane Library, EMBASE and MEDLINE via PubMed for randomized controlled trials were searched from their inception to May 2020. The methodological quality was assessed using the Physiotherapy Evidence Database sacle. All analyses were used by STATA.Results: A total of 14 articles on 13 trials were included in this meta-analysis with 673 HFpEF patients. The pooling revealed that peak oxygen uptake was improved by endurance training [MD (95% CI): 1.89 ml.kg-1.min-1 (1.32, 2.46), P < 0.001], FES [MD (95% CI): 2.28 ml.kg-1.min-1 (0.92, 3.65), P = 0.001] and IMT [MD (95% CI): 2.72 ml.kg-1.min-1 (1.44, 3.99), P < 0.001]. Similar results were observed for 6-minute walk test and QoL. Besides, endurance training increased arterial venous oxygen difference [MD (95% CI): 1.41 (0.09, 2.74), P = 0.036]. Combined exercise was beneficial to the ratio of peak early to late diastolic mitral inflow velocities [MD (95% CI): -2.90 (-4.97, -0.83), P = 0.006] and the early diastolic mitral annual velocity [MD (95% CI): 1.40 (0.68, 2.12), P = 0.006]. IMT improved ventilation/carbon dioxide ratio slope [MD (95% CI): -3.36 ml.kg-1.min-1 (-6.17, -0.54), P = 0.019].Conclusions: FES and IMT may be therapeutic options to improve functional capacity and QoL in HFpEF patients, and the outcomes are similar to endurance training. Combined exercise tends to improve diastolic function in HFpEF patients.

scholarly journals Exercise Training for Heart Failure With Preserved Ejection Fraction (ExTraMATCH III): Protocol for an Individual Patient Data Meta-Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 3-11
Author(s):  
Neil A. Smart ◽  
Melissa J. Pearson ◽  
Rod S. Taylor ◽  
John Cleland
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Related Quality ◽  
Health Related

ABSTRACT Background: We will undertake an individual patient data (IPD) meta-analysis to assess the impact of exercise-based cardiac rehabilitation in patients with heart failure with preserved ejection fraction (HFpEF) on mortality and hospitalization and quality of life of exercise-based cardiac rehabilitation according to patient characteristics: age, sex, ethnicity, New York Heart Association functional class, ischemic etiology, ejection fraction, and exercise capacity. Despite emerging evidence supporting exercise training in HFpEF, uncertainties remain in the interpretation and understanding of this evidence base. Clinicians and health care providers seek definitive estimates of impact on mortality, hospitalization and health-related quality of life (HRQoL). This work is, therefore, important as HFpEF treatment options are evolving; however, efficacy of some medications is equivocal, so optimizing exercise rehabilitation is vital. Methods: We conducted a systematic search to identify randomized trials of exercise training for at least 3 weeks compared with no exercise control with 6-month follow up or longer, providing IPD time to event on mortality or hospitalization (all-cause or heart failure-specific). IPD will be combined into a single dataset. We will use Cox proportional hazards models to investigate the effect of exercise-based cardiac rehabilitation and the interactions between exercise-based cardiac rehabilitation and participant characteristics. We will use a mix of one-stage and two-stage models. Original IPD will be requested from the authors of all eligible trials; we will check original data and compile a master dataset. IPD meta-analyses will be conducted using a one-step approach where the IPD from all studies are modeled simultaneously while accounting for the clustering of participants with studies. Results: We expect our analyses to show improved mortality, hospitalization, cardiorespiratory fitness, and health-related quality of life. Conclusion: This work will clarify exercise-based rehabilitation delivery methods to optimize benefits for people with HFpEF.

scholarly journals Quality of life in heart failure with preserved ejection fraction: importance of obesity, functional capacity, and physical inactivity

2020 ◽  
Vol 22 (6) ◽  
pp. 1009-1018 ◽  
Author(s):  
Yogesh N.V. Reddy ◽  
Aruna Rikhi ◽  
Masaru Obokata ◽  
Sanjiv J. Shah ◽  
Gregory D. Lewis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Functional Capacity ◽  
Physical Inactivity ◽  
Preserved Ejection Fraction

scholarly journals Prognostic role of anemia in heart failure with preserved ejection fraction: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Monil Majmundar ◽  
Rajkumar Doshi ◽  
Harshvardhan Zala ◽  
Palak Shah ◽  
Devina Adalja ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Prognostic Role

Catheter ablation of atrial fibrillation in patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O.M Aldaas ◽  
F Lupercio ◽  
C.L Malladi ◽  
P.S Mylavarapu ◽  
D Darden ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Catheter Ablation ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure ◽  
One Year

Abstract Background Catheter ablation improves clinical outcomes in symptomatic atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the role of catheter ablation in HF patients with a preserved ejection fraction (HFpEF) is less clear. Purpose To determine the efficacy of catheter ablation of AF in patients with HFpEF relative to those with HFrEF. Methods We performed an extensive literature search and systematic review of studies that compared AF recurrence at one year after catheter ablation of AF in patients with HFpEF versus those with HFrEF. Risk ratio (RR) 95% confidence intervals were measured using the Mantel-Haenszel method for dichotomous variables, where a RR&lt;1.0 favors the HFpEF group. Results Four studies with a total of 563 patients were included, of which 312 had HFpEF and 251 had HFrEF. All patients included were undergoing first time catheter ablation of AF. Patients with HFpEF experienced similar recurrence of AF one year after ablation on or off antiarrhythmic drugs compared to those with HFrEF (RR 0.87; 95% CI 0.69–1.10, p=0.24), as shown in Figure 1. Recurrence of AF was assessed with electrocardiography, Holter monitoring, and/or event monitoring at scheduled follow-up visits and final follow-up. Conclusion Based on the results of this meta-analysis, catheter ablation of AF in patients with HFpEF appears as efficacious in maintaining sinus rhythm as in those with HFrEF. Funding Acknowledgement Type of funding source: None

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