Wang Tianyi, Sun Lin, Niu Zhaozhuo, Wang Jixian, Wang Yuanshan
Department of Cardiac Vascular Surgery, Qingdao Municipal Hospital, 266000 Qingdao, Shandong, China.
Cardiac Surgery Unit, Qingdao Municipal Hospital, 266000 Qingdao, Shandong, China.
Rev Cardiovasc Med. 2025 May 27;26(5):27755. doi: 10.31083/RCM27755. eCollection 2025 May.
Acute aortic dissection (AAD) is a rare but life-threatening disease, and its rapid and correct diagnosis is important. Heart rate (HR) is a risk factor for death in patients with AAD, but their relationship remains unknown. This meta-analysis aimed to evaluate whether there was a significant correlation between HR and AAD mortality risk.
By searching PubMed, Embase, and Web of Science databases, the studies reporting the correlation between HR and AAD were obtained, and their methodological quality was evaluated. Relative risk (RR) with 95% confidence interval (CI) was used as the effect size. Subgroup analysis, sensitivity analysis, and publication bias test (Egger's test and funnel chart) were used to find the source of heterogeneity and evaluate the stability of the results.
Ten studies enrolling >4000 patients were included. Increased HR was positively correlated with increased AAD mortality risk (RR [95% CI] = 1.04 [1.01-1.07], = 0.006). There was significant statistical heterogeneity among the included studies. The timing of HR monitoring, AAD type, and follow-up time were sources of heterogeneity. Sensitivity analysis showed that the combined results were stable. There was a significant publication bias in the included studies; however, the shear-fill method showed that the publication bias had little effect on the combined results (RR [95% CI] = 1.038 [1.010-1.066], = 0.008).
There was a positive relationship between increased HR and increased AAD mortality.
急性主动脉夹层（AAD）是一种罕见但危及生命的疾病，快速准确的诊断至关重要。心率（HR）是AAD患者死亡的一个危险因素，但其关系尚不清楚。本荟萃分析旨在评估HR与AAD死亡风险之间是否存在显著相关性。
通过检索PubMed、Embase和Web of Science数据库，获取报道HR与AAD相关性的研究，并评估其方法学质量。采用95%置信区间（CI）的相对风险（RR）作为效应量。进行亚组分析、敏感性分析和发表偏倚检验（Egger检验和漏斗图）以寻找异质性来源并评估结果的稳定性。
纳入了10项研究，涉及4000多名患者。心率升高与AAD死亡风险增加呈正相关（RR [95% CI] = 1.04 [1.01 - 1.07]，P = 0.006）。纳入的研究之间存在显著的统计学异质性。心率监测时间、AAD类型和随访时间是异质性来源。敏感性分析表明合并结果稳定。纳入的研究存在显著的发表偏倚；然而，剪补法显示发表偏倚对合并结果影响不大（RR [95% CI] = 1.038 [1.010 - 1.066]，P = 0.008）。
心率升高与AAD死亡率增加之间存在正相关关系。
