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Wu S, Guan W, Zhao H, Li G, Zhou Y, Shi B, Zhang X. Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer. Front Physiol 2023; 14:1277383. [PMID: 38028778 PMCID: PMC10663334 DOI: 10.3389/fphys.2023.1277383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC. Methods: We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2 months. Results: Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all p < 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817-15.189, p = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093-8.372, p = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353-11.293, p = 0.012) were independent prognostic factors in ES-SCLC patients. Conclusion: Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.
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Affiliation(s)
- Shuang Wu
- School of Medicine, Yangzhou University, Yangzhou, Jiangsu, China
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, China
| | - Weizheng Guan
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Huan Zhao
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Xiaochun Zhang
- School of Medicine, Yangzhou University, Yangzhou, Jiangsu, China
- Department of Oncology, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, Jiangsu, China
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Milaras N, Dourvas P, Doundoulakis I, Sotiriou Z, Nevras V, Xintarakou A, Laina A, Soulaidopoulos S, Zachos P, Kordalis A, Arsenos P, Archontakis S, Antoniou CK, Tsiachris D, Dilaveris P, Tsioufis K, Sideris S, Gatzoulis K. Noninvasive electrocardiographic risk factors for sudden cardiac death in dilated ca rdiomyopathy: is ambulatory electrocardiography still relevant? Heart Fail Rev 2023:10.1007/s10741-023-10300-x. [PMID: 36872393 DOI: 10.1007/s10741-023-10300-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/07/2023]
Abstract
Risk stratification for sudden cardiac death in dilated cardiomyopathy is a field of constant debate, and the currently proposed criteria have been widely questioned due to their low positive and negative predictive value. In this study, we conducted a systematic review of the literature utilizing the PubMed and Cochrane library platforms, in order to gain insight about dilated cardiomyopathy and its arrhythmic risk stratification utilizing noninvasive risk markers derived mainly from 24 h electrocardiographic monitoring. The obtained articles were reviewed in order to register the various electrocardiographic noninvasive risk factors used, their prevalence, and their prognostic significance in dilated cardiomyopathy. Premature ventricular complexes, nonsustained ventricular tachycardia, late potentials on Signal averaged electrocardiography, T wave alternans, heart rate variability and deceleration capacity of the heart rate, all have both some positive and negative predictive value to identify patients in higher likelihood for ventricular arrhythmias and sudden cardiac death. Corrected QT, QT dispersion, and turbulence slope-turbulence onset of heart rate have yet to establish a predictive correlation in the literature. Although ambulatory electrocardiographic monitoring is frequently used in clinical practice in DCM patients, no single risk marker can be used for the selection of patients at high-risk for malignant ventricular arrhythmic events and sudden cardiac death who could benefit from the implantation of a defibrillator. More studies are needed in order to establish a risk score or a combination of risk factors with the purpose of selecting high-risk patients for ICD implantation in the context of primary prevention.
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Affiliation(s)
- Nikias Milaras
- National and Kapodistrian University of Athens, Athens, Greece.
- State Department of Cardiology, "Hippokration" Hospital, Vasilisis Sofias 14, 11256, Athens, Greece.
| | - Panagiotis Dourvas
- State Department of Cardiology, "Hippokration" Hospital, Vasilisis Sofias 14, 11256, Athens, Greece
| | - Ioannis Doundoulakis
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Zoi Sotiriou
- Department of Cardiology, General Hospital of Karditsa, Karditsa, Greece
| | - Vasileios Nevras
- Department of Cardiology, General Hospital of Thessaloniki Gennimatas, Thessaloniki, Greece
| | - Anastasia Xintarakou
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Aggeliki Laina
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Panagiotis Zachos
- Department of Cardiology, General Hospital of Karditsa, Karditsa, Greece
| | - Athanasios Kordalis
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Petros Arsenos
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Stefanos Archontakis
- State Department of Cardiology, "Hippokration" Hospital, Vasilisis Sofias 14, 11256, Athens, Greece
| | | | | | - Polychronis Dilaveris
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
| | - Skevos Sideris
- State Department of Cardiology, "Hippokration" Hospital, Vasilisis Sofias 14, 11256, Athens, Greece
| | - Konstantinos Gatzoulis
- First Department of Cardiology, National and Kapodistrian University, Hippokration" Hospital, Athens, Greece
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Qin J, Wang W, Wei P, Huang P, Lin R, Yue J. Effects of sacubitril-valsartan on heart failure patients with mid-range ejection fractions: A systematic review and meta-analysis. Front Pharmacol 2022; 13:982372. [PMID: 36353496 PMCID: PMC9638065 DOI: 10.3389/fphar.2022.982372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/12/2022] [Indexed: 09/22/2023] Open
Abstract
Aim: The effect of sacubitril-valsartan (ARNI) in heart failure (HF) patients with mid-range ejection fractions (HFmrEF) remains unclear. This study aimed to investigate the effects of ARNI in HFmrEF patients. Methods: From inception to 15 February 2022, articles were searched via PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Whip, and Wanfang databases. Left ventricular functions, indicators related to HF, quality of life score, 6-Minute Walk Test, total effective rate, mortality, readmission rate, and adverse events were the outcomes. Relative risk (RR), weighted mean difference (WMD), and 95% confidence interval (CI) were used to evaluate the outcomes. The heterogeneity test was conducted for each indicator and measured by I2 statistics. Subgroup analysis was performed regarding the type of study and duration of treatment. Results: Sixteen studies involving 1,937 patients were included in this study. Our results showed ARNI was likely to improve left ventricular function by increasing the left ventricular ejection fraction (LVEF) (WMD: 2.36, 95%CI: 1.09-3.62), stroke volume (WMD: 16.800, 95%CI: 11.385-22.215), and left ventricular short-axis shortening rate (WMD: 2.05, 95%CI: 0.25-3.86), decreasing left ventricular end-diastolic dimension (WMD: -2.48, 95%CI: -3.83 to -1.13), left atrial diameter (WMD: -2.23, 95%CI: -2.83 to -1.63), C-reactive protein level (WMD: -1.40, 95%CI: -2.62 to -0.18), and N-terminal-pro B-type natriuretic peptide level (WMD: -494.92, 95%CI: -641.34 to -348.50). ARNI has a higher total effective rate (RR: 1.15, 95%CI: 1.08-1.21), Kansas City cardiomyopathy questionnaire (WMD: 4.13, 95%CI: 3.46-4.81), and 6-Minute Walk Test (WMD: 51.35, 95%CI: 26.99-75.71) compared with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). In addition, ARNI decreased the readmission rate (RR: 0.54, 95%CI: 0.43-0.68) (all p < 0.05). Nevertheless, there were no significant differences in the adverse outcomes. Conclusion: This meta-analysis suggests ARNI may be an effective strategy with which to improve the left ventricular function, and quality of life, and reduce the readmission rate in HFmrEF patients. However, long-term clinical studies with large samples are still needed to further explore the efficacy and safety of ARNI compared with ACEI or ARB in the HFmrEF population.
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Affiliation(s)
| | | | | | | | | | - Jinming Yue
- Department of Cardiology, Wuzhou Red Cross Hospital, Wuzhou, China
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Tan Y, Chen H, Li J, Wu Q, Wu X, Zhao W. Traditional Chinese medicine on treating dilated cardiomyopathy: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e20777. [PMID: 32629659 PMCID: PMC7337424 DOI: 10.1097/md.0000000000020777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is a type of complex cardiomyopathy characterized by enlargement and contractile dysfunction of the left ventricle, right ventricle, or double ventricle. Modern studies have shown that the pathogenesis of DCM is closely related to factors such as heredity, gene mutation, autoimmunity, and viral infection. The etiology is complex and the mortality rate is high. Many clinical trials have proved that traditional Chinese medicine has a great therapeutic effect on DCM. In this systematic review, we aim to evaluate the effectiveness and safety of traditional Chinese medicine for DCM. METHODS The databases of Pubmed, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WANFANG Data), Weipu Information Chinese Periodical Service Platform (VIP), and China Biomedical Literature Service System (SinoMed) will be searched online to collect randomized controlled trials related to the treatment of DCM with Traditional Chinese medicine The time is limited from the construction of the library to December 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata 13.0 software so as to systematically review the effectiveness of Traditional Chinese medicine for DCM. ETHICS AND DISSEMINATION This systematic review will evaluate the efficacy and safety of traditional Chinese medicine for DCM. Because all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. In addition, all data will be analyzed anonymously during the review process. TRIAL REGISTRATION NUMBER PROSPERO CRD42020163332.
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Affiliation(s)
- Yuqing Tan
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
- Beijing University of Chinese Medicine, Beijing, China
| | - Hengwen Chen
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Jun Li
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Qingjuan Wu
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Xiaobo Wu
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
- Beijing University of Chinese Medicine, Beijing, China
| | - Wei Zhao
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
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