Kathleen P Nolan, Daniel Z Grunspan, Erika Myler, Nava Brimble, Andreas Heyland, Robert H Hanner
DNA at the whim of the water: environmental DNA as a course-based undergraduate research experience
Genome
heart failure preserved ejection fraction hfpef accounts 50 heart failure cases associated significant morbidity health system burden date limited treatment options proven improve outcomes patients sodium glucose cotransporter 2 sglt2 inhibitors first class drug demonstrate significant clinical benefits including reductions heart failure hospitalisation obesity associated forms heart failure linked worse clinical outcomes numerous reviews support benefits weight loss heart failure specifically patients heart failure reduced ejection fraction however evidence hfpef patients less clear limited pharmacotherapy options growing support weight loss patients hfpef systematic review metaanalysis aims examine effects lifestyle interventions weight loss health outcomes patients hfpef web science embase scopus pubmed databases searched identify relevant studies february 2023 included studies randomised controlled trials duration four weeks lifestyle interventions conducted adults hfpef reported weight loss outcomes interest body weight body mass index bmi blood pressure systolic diastolic aerobic capacity 6minute walk distance new york heart association nyha functional classification selfreported health quality life minnesota living heart failure questionnaire mlhfq nterminal pro btype natriuretic peptide ntprobnp levels review manager software used conduct random effect metaanalyses forest plots generated outcome betweenstudy heterogeneity estimated using i2 test statistic riskofbias assessment used cochrane riskofbias tool certainty evidence assessed using grade 2282 records identified six studies total 375 participants three six months duration included systematic review metaanalysis lifestyle interventions consisted diet exercise combination diet exercise education exercise mean followup 45 months pooled effects interventions associated reduction body weight 5kg weight mean difference wmd 530 kg 95 ci 872 187 p0002 reduction resting systolic wmd 298 mmhg 95 ci 420 176 p0001 diastolic blood pressure wmd 451 mmhg 95 ci 839 064 p002 compared received usual care interventions also improved 6minute walk distance wmd 4363 95 ci 2228 6497 p0001 nyha class wmd 054 95 ci 075 033 p0001 mlhfq score wmd 1777 95 cl 1900 1653 p0001 patients hfpef lifestyle intervention associated significant reduction body weight favourable effects blood pressure aerobic capacity nyha class healthrelated quality life research needed population examine feasibility durability weight loss interventions examine potential impact hard clinical endpoints