儿童癌症幸存者的心肺适应性：系统评价和荟萃分析
Cardiorespiratory Fitness in Childhood Cancer Survivors: A Systematic Review and Meta-Analysis
影响因子:7.50000
分区:医学1区 Top / 心脏和心血管系统2区
发表日期:2024 Oct 04
作者:
Kaitlyn Weinkauf, Emma Fyfe, Dean Hewitt, Jing Wang, Megan Kennedy, Edith Pituskin, Andre La Gerche, Stephen J Foulkes, Mark J Haykowsky
摘要
心血管疾病（CVD）是儿童癌症幸存者（CCS）死亡率的主要原因，可能与放射或化学疗法的心脏毒性作用以及心脏呼吸适应性的降低有关。因此，我们试图比较CCS和年龄匹配的非癌症对照（CON）之间的心肺适应性（峰值氧气吸收，VİO2PEAK）。次要结果包括血液动力学和静息心功能。Embase，Scopus，Medline，Cinahl和SportDiscus数据库从Inception到2023年6月进行了合格的研究。包括在CCS和CON中测得的Vïo2peak的横断面研究。根据固定效应荟萃分析和组差异之间的估计，结果和汇总估计值的差异被报告为加权平均差异（WMD）（WMD）。发现2026年的研究，有18个报道了Vïo2peak（CCS：n = 786，44％，女性，女性，平均年龄：16岁，年龄：16岁，时间：5.8岁。 CCS中的Vïo2peak较低（WMD：-7.08ml/kg/min，95％CI：-7.75至-6.42，I2：79％，n = 2,165），峰值运动心脏速度没有差异（WMD：-1.4Bpm，95％CI：-1.4BPM，95％CI：-3.0至0.2％至0.2％，I2：63％。静止左心室射血分数（WMD：-1.61％，95％CI：-2.60至-0.62，I2。 4.9bpm; 95％CI：1.8至7.9，i2：55％，n = 262）.CCS的心肺适应性显着降低（比CON低7.1ml/kg/min），这可能对他们未来的CVD和死亡率具有重要的预后。
Abstract
Cardiovascular disease (CVD) is a leading cause of mortality in childhood cancer survivors (CCS) that may be related to the cardiotoxic effects of radiation or chemotherapy and concomitant reductions in cardiorespiratory fitness. Therefore, we sought to compare cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) between CCS and age-matched non-cancer controls (CON). Secondary outcomes included hemodynamics and resting cardiac function.Embase, Scopus, MEDLINE, CINAHL and SPORTDiscus databases were searched from inception to June 2023 for eligible studies. Cross-sectional studies with V̇O2peak measured in CCS and CON were included. Differences in outcomes and pooled estimates for each outcome were estimated from a fixed effects meta-analysis and between group differences were reported as a weighted mean difference (WMD).Of 2026 studies identified, 18 reported V̇O2peak (CCS: n=786, 44% female, mean age: 16-years, time post-therapy: 5.8 years; CON: n=1379, 50% female, mean age: 16-years). V̇O2peak was lower in CCS (WMD: -7.08mL/kg/min, 95% CI: -7.75 to -6.42, I2: 79%, n=2,165) with no difference for peak exercise heart rate (WMD: -1.4bpm, 95% CI: -3.0 to 0.2, I2: 63%, n=741). Resting left-ventricular ejection fraction (WMD: -1.61%, 95% CI: -2.60 to -0.62, I2.: 49%, n=222) and systolic blood pressure were lower (WMD: -3.8mmHg, 95% CI: -5.7 to -1.9, I2: 25%, n=184) while resting heart rate was higher in CCS (WMD: 4.9bpm; 95% CI: 1.8 to 7.9, I2: 55%, n=262).CCS have a marked reduction in cardiorespiratory fitness (7.1ml/kg/min lower than CON) that may have important prognostic implications for their future risk of CVD and mortality.