Effectiveness of implantation of cardioverter-defibrillators therapy in patients with non-ischemic heart failure: an updated systematic review and meta-analysis

Abstract Objective: Implantable cardioverter-defibrillator has become the first-line therapy for prevention of sudden cardiac death. Controversial results still exist regarding the effectiveness of implantable cardioverter-defibrillator (ICD) in non-ischemic heart failure. Methods: The PubMed, Embase, and Cochrane Central databases were searched for randomized trials comparing implantable cardioverter-defibrillator in combination with medical treatment versus medical treatment for non-ischemic heart failure. The primary endpoint was incidence of all-cause death. We derived pooled risk ratios with fixed-effects models. Results: Five studies enrolling 2573 patients were included. Compared with medical treatment, implantable cardioverter-defibrillator with medical treatment was associated with a significantly lower risk for all-cause mortality (Risk ratio: 0.83; 95% confidence interval 0.71 to 0.97). Conclusion: Compared with medical treatment only, implantable cardioverter-defibrillator in combination with medical treatment reduces all-cause mortality.

MicroRNAs and mesenchymal stem cells: hope for pulmonary hypertension / MicroRNAs e células-tronco mesenquimais: esperança para a hipertensão pulmonar

AbstractPulmonary hypertension is a devastating and refractory disease and there is no cure for this disease. Recently, microRNAs and mesenchymal stem cells emerged as novel methods to treat pulmonary hypertension. More than 20 kinds of microRNAs may participate in the process of pulmonary hypertension. It seems microRNAs or mesenchymal stem cells can ameliorate some symptoms of pulmonary hypertension in animals and even improve heart and lung function during pulmonary hypertension. Nevertheless, the relationship between mesenchymal stem cells, microRNAs and pulmonary hypertension is not clear. And the mechanisms underlying their function still need to be investigated. In this study we review the recent findings in mesenchymal stem cells - and microRNAs-based pulmonary hypertension treatment, focusing on the potential role of microRNAs regulated mesenchymal stem cells in pulmonary hypertension and the role of exosomes between mesenchymal stem cells and pulmonary hypertension.

ResumoA hipertensão pulmonar é uma doença devastadora e refratária, para a qual não existe cura. Recentemente, microRNAs e células-tronco mesenquimais emergiram como novos métodos para tratar a hipertensão pulmonar. Mais de 20 tipos de microRNAs podem participar no processo de hipertensão pulmonar. Ao que parece, microRNAs ou células-tronco mesenquimais podem atenuar alguns sintomas de hipertensão pulmonar em animais de e até mesmo melhorar a função cardíaca e do pulmão durante a hipertensão pulmonar. No entanto, a relação entre células-tronco mesenquimais, microRNAs e hipertensão pulmonar não é clara. E os mecanismos subjacentes a sua função ainda precisam ser investigados. Neste estudo, revisamos as descobertas recentes no tratamento da hipertensão pulmonar baseado em células-tronco mesenquimais e microRNAs, enfocando o papel potencial dos microRNAs para regular as células-tronco mesenquimais na hipertensão pulmonar e o papel dos exossomos entre células-tronco mesenquimais e hipertensão pulmonar.