Wu Yuan, Zhu Haixiang, Xu Qijin, Li Yan, Tang Leiwen
Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Coron Artery Dis. 2025 May 1;36(3):252-262. doi: 10.1097/MCA.0000000000001440. Epub 2024 Oct 24.
Angina with nonobstructive coronary arteries (ANOCA) is a highly prevalent heart disease. The evidence on exercise training (ET) for the treatment of ANOCA, however, is still inadequate. This meta-analysis aims to provide a comprehensive assessment of the effect of ET in patients with ANOCA. Studies were searched from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP, and WanFang from inception to 15 January 2024. The quality of included studies was assessed using the Cochrane risk of bias tool. Heterogeneity among the studies was evaluated using Cochran's Q test and I2 statistic, and subgroup analysis based on gender was performed to explore potential sources of heterogeneity. A total of 12 studies were included in this meta-analysis. The pooled results showed that ET significantly increased the peak oxygen uptake (peak VO 2 ) [weighted mean difference (WMD) = 6.11, 95% confidence interval (CI): 4.73 to 7.50], left ventricular ejection fraction (WMD = 7.66, 95% CI: 5.53 to 9.78), and 6 min walking test (WMD = 55.55; 95% CI: 16.23 to 94.87). Nitric oxide (WMD = 20.18, 95% CI: 19.16 to 21.21) and peripheral arterial tonometry (WMD = 0.16, 95% CI: 0.11 to 0.21) were higher, and matrix metalloproteinase-9 (WMD = -8.02, 95% CI: -9.21 to -6.84) was lower in ET group. In conclusion, our findings indicated that ET could improve cardiopulmonary function, exercise capacity, and endothelial function, which could be recommended for the treatment of ANOCA patients.
非阻塞性冠状动脉性心绞痛（ANOCA）是一种非常常见的心脏病。然而，关于运动训练（ET）治疗ANOCA的证据仍然不足。这项荟萃分析旨在全面评估ET对ANOCA患者的疗效。从创刊至2024年1月15日，在PubMed、Embase、Cochrane图书馆、科学网、中国知网、维普和万方数据库中进行检索。使用Cochrane偏倚风险工具评估纳入研究的质量。采用Cochran's Q检验和I²统计量评估研究间的异质性，并基于性别进行亚组分析以探索潜在的异质性来源。本荟萃分析共纳入12项研究。汇总结果显示，ET显著提高了峰值摄氧量（峰值VO₂）[加权均数差（WMD）=6.11，95%置信区间（CI）：4.73至7.50]、左心室射血分数（WMD=7.66，95%CI：5.53至9.78）和6分钟步行试验（WMD=55.55；95%CI：16.23至94.87）。ET组一氧化氮（WMD=20.18，95%CI：19.16至21.21）和外周动脉张力测量值（WMD=0.16，95%CI：0.11至0.21）较高，基质金属蛋白酶-9（WMD=-8.02，95%CI：-9.21至-6.84）较低。总之，我们的研究结果表明，ET可以改善心肺功能、运动能力和内皮功能，可推荐用于治疗ANOCA患者。
