{"title":"心脏康复对心血管疾病患者勃起功能障碍的影响：系统回顾和荟萃分析。","authors":"Masoumeh Sadeghi, Ali Askari, Fatemeh Bostan, Afshin Heidari, Hamed Rafiee, Ghazaal Alavi Tabatabaei, Golsa Ghasemi, Hamidreza Roohafza","doi":"10.1093/sexmed/qfae043","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.</p><p><strong>Aim: </strong>To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.</p><p><strong>Outcomes: </strong>The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.</p><p><strong>Results: </strong>A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (<i>I</i> <sup>2</sup> = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.</p><p><strong>Clinical translation: </strong>CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.</p><p><strong>Strengths and limitations: </strong>The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.</p><p><strong>Conclusion: </strong>The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215551/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis.\",\"authors\":\"Masoumeh Sadeghi, Ali Askari, Fatemeh Bostan, Afshin Heidari, Hamed Rafiee, Ghazaal Alavi Tabatabaei, Golsa Ghasemi, Hamidreza Roohafza\",\"doi\":\"10.1093/sexmed/qfae043\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.</p><p><strong>Aim: </strong>To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.</p><p><strong>Outcomes: </strong>The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.</p><p><strong>Results: </strong>A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (<i>I</i> <sup>2</sup> = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.</p><p><strong>Clinical translation: </strong>CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.</p><p><strong>Strengths and limitations: </strong>The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.</p><p><strong>Conclusion: </strong>The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).</p>\",\"PeriodicalId\":21782,\"journal\":{\"name\":\"Sexual Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215551/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sexual Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/sexmed/qfae043\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/sexmed/qfae043","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：目的：通过系统回顾和荟萃分析，评估心脏康复（CR）对心血管疾病患者勃起功能障碍（ED）的影响：本研究分析了针对患有任何心脏疾病的成年男性（≥18 岁）的随机对照试验和其他研究，这些试验和研究对 CR 与常规护理进行了比较。研究人员进行了广泛的文献检索，并使用 Cochrane 协作工具对偏倚风险进行了评估。荟萃分析纳入了涉及 668 名参与者的 6 项研究数据：主要研究结果是通过国际勃起功能指数（International Index of Erectile Function）衡量的勃起功能障碍改善情况：6项研究均观察到勃起功能有明显改善，莫里斯dppc2效应大小为0.38（95% CI，0.17-0.59）。尽管最初的异质性较高（I 2 = 95.7%），但对选择性结果报告偏倚的识别和纠正缓解了这一问题：CR对改善心血管疾病患者的ED有一定的影响，但在统计学上有显著意义，这表明CR对提高该群体的生活质量具有潜在的积极作用：该研究的优点包括全面的文献检索和严谨的方法论。局限性包括研究间的高度异质性，以及由于样本量小和研究质量而导致的低证据水平；不过，经过偏倚风险评估，异质性的来源已被识别并得到缓解：结果表明，CR 对改善心血管疾病患者的 ED 有显著的统计学意义，但影响不大。临床医生应考虑将 CR 纳入这些患者的临床管理中。这项研究强调了 CR 通过解决相关的 ED 问题来提高心血管疾病患者生活质量的潜力 (PROSPERO: CRD42022374625)。
Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis.
Background: Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.
Aim: To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.
Methods: This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.
Outcomes: The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.
Results: A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (I2 = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.
Clinical translation: CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.
Strengths and limitations: The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.
Conclusion: The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).
期刊介绍：
Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
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