新型冠状病毒肺炎患者影像学左心室舒张功能障碍的发病率、危险因素及预后影响：系统评价方案
Incidence, risk factors and prognostic effect of imaging left ventricular diastolic dysfunction in patients with COVID-19: protocol for a systematic review.
作者信息
Tian LiJuan, Duan Fujian, Li XingHuan, Zhou Chenghui
机构信息
Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Anesthesiology, Yunnan Fuwai Cardiovascular Hospital, Kunming, China.
出版信息
BMJ Open. 2022 Apr 27;12(4):e059281. doi: 10.1136/bmjopen-2021-059281.
INTRODUCTION
Recent reports linked acute COVID-19 infection in critical patients to cardiac structure and function abnormalities. The left ventricular (LV) diastolic dysfunction could result in obvious adverse prognostic impacts. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging LV diastolic dysfunction in adult patients with COVID-19.
METHODS
Databases to be used for the pertinent literature are PubMed, EMBase, ISI Knowledge via Web of Science, and preprint databases (MedRxiv and BioRxiv) (until May 2023) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of LV diastolic dysfunction assessed by echocardiography or cardiac MRI. Secondary outcomes will include the risk factors for LV diastolic dysfunction and the association with all-cause mortality during hospitalisation. Additional outcomes will be septal or lateral é, average E/é, E/A, peak tricuspid regurgitation velocity, left atrial volume index and LV wall thickness. Univariable or multivariable meta-regression and subgroup analyses will be conducted for related risk factors and the association of LV diastolic dysfunction with all-cause mortality. Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of LV diastolic dysfunction incidence and related risk factors, association with all-cause mortality and other LV diastolic dysfunction parameters.
ETHICS AND DISSEMINATION
There was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.
PROSPERO REGISTRATION NUMBER
CRD42021256666; URL: https://www.crd.york.ac.uk/prospero/.
引言
近期报告将危重症患者的急性新冠病毒感染与心脏结构和功能异常联系起来。左心室舒张功能障碍可能会导致明显的不良预后影响。本荟萃分析的目的是总结新冠病毒感染成年患者左心室舒张功能障碍的发生率、危险因素及影像学评估的预后影响。
方法
用于检索相关文献的数据库包括PubMed、EMBase、通过Web of Science检索的ISI Knowledge以及预印本数据库（MedRxiv和BioRxiv）（截至2023年5月），以识别所有关于新冠病毒感染成年患者的队列研究。主要结局将是通过超声心动图或心脏磁共振成像评估的左心室舒张功能障碍的发生率。次要结局将包括左心室舒张功能障碍的危险因素以及与住院期间全因死亡率的关联。其他结局将是室间隔或侧壁e'、平均E/e'、E/A、三尖瓣反流峰值速度、左心房容积指数和左心室壁厚度。将对相关危险因素以及左心室舒张功能障碍与全因死亡率的关联进行单变量或多变量Meta回归及亚组分析。敏感性分析将通过一次移除每项纳入研究来评估结果的稳健性，以获得并评估左心室舒张功能障碍发生率及相关危险因素、与全因死亡率的关联以及其他左心室舒张功能障碍参数的剩余总体估计值。
伦理与传播
根据阜外医院机构审查委员会/独立伦理委员会的规定，本系统评价方案无需伦理批准。本荟萃分析将通过同行评审期刊发表进行传播。
PROSPERO注册号：CRD42021256666；网址：https://www.crd.york.ac.uk/prospero/
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