PMID- 30317416
OWN - NLM
STAT- MEDLINE
DCOM- 20200512
LR  - 20210109
IS  - 1573-7322 (Electronic)
IS  - 1382-4147 (Linking)
VI  - 24
IP  - 2
DP  - 2019 Mar
TI  - Autonomic regulation device therapy in heart failure with reduced ejection 
      fraction: a systematic review and meta-analysis of randomized controlled trials.
PG  - 245-254
LID - 10.1007/s10741-018-9745-5 [doi]
AB  - Heart failure with reduced ejection fraction (HFrEF) represents a significant 
      public health burden associated with incremental health care costs. Given the 
      limitations associated with pharmacological autonomic regulation therapy (ART), 
      device-based autonomic neuromodulation is on the horizon now for ART in those 
      patients. This systematic review aimed primarily to determine the effect of ART 
      by devices on functional status and quality of life (QOL) in patients with HFrEF. 
      We performed a meta-analysis of five randomized controlled trials (1074 patients) 
      comparing ART by devices versus optimal medical therapy (OMT) in HFrEF. We 
      assessed pooled estimates of odds ratio (OR) for improvement in New York Heart 
      Association (NYHA) class and mean differences (MD) in 6-minute hall walk distance 
      (6-MHWD), Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, 
      N-terminal pro b-type natriuretic peptide (NT-proBNP) levels, and left 
      ventricular end-systolic volume index (LVESVi) with their 95% confidence 
      intervals (CIs) at 6-month follow-up. Compared to OMT alone, ART by devices in 
      HFrEF significantly improves NYHA class (OR 2.26, 95% CI 1.33 to 3.83, 
      P = 0.003), increases 6-MHWD (MD 45.53 m, 95% CI 30.61 to 60.45, P < 0.00001), 
      improves MLHFQ score (MD - 10.59, 95% CI - 20.62 to - 0.57, P = 0.04) with 
      neutral effect on NT-proBNP levels (MD - 236.5 pg/ml, 95% CI - 523.86 to 50.87, 
      P = 0.11) and LVESVi (MD - 1.01 ml/m(2), 95% CI - 4.49 to 2.47, P = 0.57). We 
      concluded that device-based neuromodulation therapy significantly improves 
      functional status and quality of life in patients with HFrEF.
FAU - Bendary, Ahmed
AU  - Bendary A
AUID- ORCID: 0000-0002-0161-3779
AD  - Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, 13518, 
      Egypt. ahmed.bendari@fmed.bu.edu.eg.
FAU - Bendary, Mohamed
AU  - Bendary M
AD  - Department of Biostatistics, National Cancer Institute, Cairo University, Giza, 
      Egypt.
FAU - Salem, Mohamed
AU  - Salem M
AD  - Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, 13518, 
      Egypt.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Autonomic Nervous System/*physiopathology
MH  - Female
MH  - Health Care Costs/statistics & numerical data
MH  - Heart Failure/economics/*physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
MH  - Vagus Nerve Stimulation/*instrumentation
MH  - Ventricular Function, Left/physiology
MH  - Walk Test/statistics & numerical data
OTO - NOTNLM
OT  - Autonomic regulation
OT  - Devices
OT  - Heart failure
EDAT- 2018/10/15 06:00
MHDA- 2020/05/13 06:00
CRDT- 2018/10/15 06:00
PHST- 2018/10/15 06:00 [pubmed]
PHST- 2020/05/13 06:00 [medline]
PHST- 2018/10/15 06:00 [entrez]
AID - 10.1007/s10741-018-9745-5 [pii]
AID - 10.1007/s10741-018-9745-5 [doi]
PST - ppublish
SO  - Heart Fail Rev. 2019 Mar;24(2):245-254. doi: 10.1007/s10741-018-9745-5.