Esmaeili Zahra, Bahiraie Pegah, Vaziri Zahra, Azarboo Alireza, Behnoush Amir Hossein, Khalaji Amirmohammad, Bazrgar Aida, Tayebi Pouya, Ziaie Naghmeh
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Cardiovasc Med. 2024 Jul 23;11:1435677. doi: 10.3389/fcvm.2024.1435677. eCollection 2024.
The arterial stiffness measured by pulsed wave velocity (PWV) is associated with heart failure (HF). However, the effectiveness of arterial stiffness and PWV as prognostic indicators in patients with HFpEF and HFrEF is still unclear. In this systematic review and meta-analysis, we synthesized the prognostic value of PWV and arterial stiffness in HF patients.
Four databases, including Embase, PubMed, Scopus, and Web of Science, were systematically searched for published studies assessing the relationship between PWV and HF from inception up to August 31, 2023. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. The standardized mean difference (SMD) and their corresponding 95% confidence intervals (CI) were used to compare PWV in HF (HFrEF and HFpEF) and controls. Meta-regressions based on age, year of publication, sample size, and gender (male percentage) were also conducted.
The systematic search yielded 5,977 results, of which 58 met our inclusion criteria and 24 were analyzed quantitatively. Studies included 64,687 patients with a mean age of 53.7 years, and 41,803 (67.3%) were male. Meta-analysis of 19 studies showed that PWV was significantly higher in HF patients compared to the controls (SMD 1.04, 95% CI 0.43-1.66, < 0.001, = 93%). Moreover, nine studies have measured PWV among HFrEF and HFpEF patients and found no significant difference (SMD -0.51, 95% CI -1.03 to 0.02, = 0.057, I2 = 95%). Moreover, increased PWV was linked to an increased chance of developing new-onset HF in individuals with cardiovascular risk factors.
Patients with HF exhibit significantly higher arterial stiffness, as indicated by PWV, compared to the normal population. However, this association was not significant between HFrEF and HFpEF patients. Future research is warranted to establish the potential prognostic role of PWV in HF.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023479683, PROSPERO (CRD42023479683).
通过脉搏波速度（PWV）测量的动脉僵硬度与心力衰竭（HF）相关。然而，在射血分数保留的心力衰竭（HFpEF）和射血分数降低的心力衰竭（HFrEF）患者中，动脉僵硬度和PWV作为预后指标的有效性仍不明确。在这项系统评价和荟萃分析中，我们综合了PWV和动脉僵硬度在HF患者中的预后价值。
系统检索了四个数据库，包括Embase、PubMed、Scopus和Web of Science，以查找从创刊至2023年8月31日发表的评估PWV与HF之间关系的研究。采用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。使用标准化均数差（SMD）及其相应的95%置信区间（CI）比较HF（HFrEF和HFpEF）患者和对照组的PWV。还基于年龄、发表年份、样本量和性别（男性百分比）进行了荟萃回归分析。
系统检索得到5977条结果，其中58条符合我们的纳入标准，24条进行了定量分析。研究纳入了64687例患者，平均年龄53.7岁，41803例（67.3%）为男性。对19项研究的荟萃分析表明，与对照组相比，HF患者的PWV显著更高（SMD 1.04，95%CI 0.43 - 1.66，P < 0.001，I² = 93%）。此外，9项研究测量了HFrEF和HFpEF患者的PWV，发现无显著差异（SMD -0.51，95%CI -1.03至0.02，P = 0.057，I² = 95%）。此外，PWV升高与有心血管危险因素的个体发生新发HF的几率增加有关。
与正常人群相比，HF患者的动脉僵硬度明显更高，这通过PWV得以体现。然而，HFrEF和HFpEF患者之间的这种关联并不显著。未来有必要开展研究以确定PWV在HF中的潜在预后作用。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023479683，PROSPERO（CRD42023479683）
