Exercise training to reduce sympathetic nerve activity in heart failure patients. A systematic review and meta-analysis.
Exercise training to reduce sympathetic nerve activity in heart failure patients. A systematic review and meta-analysis.
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DOI：
10.1016/j.bjpt.2017.06.014
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发表时间：
2018-03
影响因子：
3.4
通讯作者：
Rodríguez-Núñez I
中科院分区：
文献类型：
--
作者：
Saavedra MJ;Romero F;Roa J;Rodríguez-Núñez I
心力衰竭与以交感神经亢进为特征的心血管系统自主神经功能障碍有关。运动干预促进了恢复自主神经平衡的机制。运动训练对心力衰竭患者交感神经活动的影响尚未总结。在心力衰竭患者中，与未接受训练的患者相比，运动训练会降低交感神经活性。所有研究的证据质量中等，研究的异质性很高。目的：探讨运动训练对心力衰竭患者交感神经活动的影响。进行了系统的综述。计算机检索MEDLINE、ProQuest、SciELO、SPORTDiscus、康复和运动医学来源、护理和相关健康文献的累积索引、Tripdatabase、Science Direct和Pedro。临床试验和准实验研究被考虑作为主要文献的选择。这些研究应该包括被诊断为慢性心力衰竭的患者，这些患者至少进行了4周的运动训练。干预前后用显微神经像仪测定交感神经活动。Cochrane Collaboration的偏差风险工具被用来评估偏见的风险，并根据等级方法对证据质量进行评级。计算对照组和实验组的标准化均数差(SMD)。采用随机效应模型进行Meta分析。共纳入5项试验。总体而言，这些试验有中等偏向的风险。与对照组相比，实验组的每分钟猝发次数显著减少(SmD−2.48；95%CI−3.55至−1.41)。同时，与对照组相比，实验组每百次心搏爆发的发生率也显著降低(SmD−2.66；95%CI−3.64至−1.69)。运动训练可有效降低心力衰竭患者的交感神经活动。所有研究的证据质量都是中等的。需要进一步的研究来证实这些结果。
Heart failure is associated to autonomic dysfunction of cardiovascular system characterized by sympathetic hyperactivity. Exercise intervention promotes mechanisms that restores the autonomic balance. The effects of exercise training on sympathetic nerve activity in heart failure patients have not been summarized. In patients with heart failure, exercise training reduces sympathetic nerve activity compared with non-trained patients. The quality of evidence across the studies was moderate and the heterogeneity across the studies was high. To determine the effects of exercise training on sympathetic nerve activity in heart failure patients. A systematic review was performed. An electronic search of MEDLINE, ProQuest, SciELO, SPORTDiscus, Rehabilitation and Sport Medicine Source, Cumulative Index to Nursing and Allied Health Literature, Tripdatabase, Science Direct and PEDrO was performed from their inception to February 2017. Clinical trials and quasi-experimental studies were considered for primary article selection. The studies should include patients diagnosed with chronic heart failure that performed exercise training for at least 4 weeks. Sympathetic nerve activity should be measured by microneurography before and after the intervention. The Cochrane Collaboration's Risk of Bias Tool was used to evaluate risk of bias, and the quality of evidence was rated following the GRADE approach. Standardized mean differences (SMD) were calculated for control and experimental groups. Meta-analysis was performed using the random effects model. Five trials were included. Overall, the trials had moderate risk of bias. The experimental group indicated a significant decrease in the number of bursts per minute (SMD −2.48; 95% CI −3.55 to −1.41) when compared to the control group. Meanwhile, a significant decrease was also observed in the prevalence of bursts per 100 beats in the experimental group when compared to the control group (SMD −2.66; 95% CI −3.64 to −1.69). Exercise training could be effective in reducing sympathetic nerve activity in patients with heart failure. The quality of evidence across the studies was moderate. Future studies are necessary to confirm these results.
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影响因子：
37.8
作者：
Bibbins-Domingo, K;Lin, F;Shlipak, MG
通讯作者：
Shlipak, MG
DOI：
10.1152/ajpheart.00136.2014
发表时间：
2014-12-01
影响因子：
4.8
作者：
Antunes-Correa, Ligia M.;Nobre, Thais S.;Negrao, Carlos E.
通讯作者：
Negrao, Carlos E.
DOI：
10.1590/s0100-879x2011000900004
发表时间：
2011-09-01
影响因子：
2.3
作者：
Martins-Pinge, M.C.
通讯作者：
Martins-Pinge, M.C.
影响因子：
3.4
作者：
Mancini, Marisa C.;Cardoso, Jefferson R.;Costa, Leonardo O. P.
通讯作者：
Costa, Leonardo O. P.
影响因子：
18.2
作者：
de Mello Franco, Fabio Gazelato;Santos, Amilton C.;Barretto, Antonio C. Pereira
通讯作者：
Barretto, Antonio C. Pereira