The Use of Metabolomes in Risk Stratification of Heart Failure Patients: Protocol for a Scoping Review.

BACKGROUND: Heart failure (HF) is a significant health problem that is often associated with major morbidity and mortality. Metabolic abnormalities occur in HF and may be used to identify individuals at risk of developing the condition. Furthermore, these metabolic changes may play a role in the pathogenesis and progression of HF. Despite this knowledge, the utility of metabolic changes in diagnosis, management, prognosis, and therapy for patients with chronic HF has not been systematically reviewed. OBJECTIVE: This scoping review aims to systematically appraise the literature on metabolic changes in patients with HF, describe the role of these changes in pathogenesis, progression, and care, and identify knowledge gaps to inform future research. METHODS: This review will be conducted using a strategy based on previous reports, the JBI Manual for Evidence Synthesis, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search of electronic databases (Medline, EBSCOhost, Scopus, and Web of Science) will be conducted using keywords related to HF, myocardial failure, metabolomes, metabonomics, and analytical chemistry techniques. The search will include original peer-reviewed research papers (clinical studies conducted on humans and systematic reviews with or without a meta-analysis) published between January 2010 and September 2023. Studies that include patients with HF younger than 18 years or those not published in English will be excluded. Two authors (UGA and MB) will screen the titles and abstracts independently and perform a full-text screen of the relevant and eligible papers. Relevant data will be extracted and synthesized, and a third author or group will be consulted to resolve discrepancies. RESULTS: This scoping review will span from January 2010 to September 2023, and the results will be published in a peer-reviewed, open-access journal as a scoping review in 2024. The presentation of the findings will use the PRISMA-ScR flow diagram and descriptive and narrative formats, including tables and graphical displays, to provide a comprehensive overview of the extracted data. CONCLUSIONS: This review aims to collect and analyze the available evidence on metabolic changes in patients with HF, aiming to enhance our current understanding of this topic. Additionally, this review will identify the most commonly used and suitable sample, analytical method, and specific metabolomes to facilitate standardization, reproducibility of results, and application in the diagnosis, treatment, and risk stratification of patients with HF. Finally, it is hoped that this review's outcomes will inspire further research into the metabolomes of patients with HF in low- and middle-income countries. TRIAL REGISTRATION: Open Science Framework; https://osf.io/sp6xj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53905.

Hypertensive Disorders in Pregnancy: Pattern and Obstetric Outcome in Bida, Nigeria.

CONTEXT: Cases of hypertensive disorders in pregnancy (HDP) are an increase in developing economies. Identifying the pattern of HDP in a particular community and documenting their management outcome may allow for proper planning by all stakeholders. AIMS: The objective was to determine the pattern and management outcome of hypertensive disorders among pregnant women. SETTINGS AND DESIGN: This was a prospective cohort study involving 183 consecutive cases of HDP at Federal Medical Centre, Bida, Niger State, Nigeria, between September 2015 and August 2016. SUBJECTS AND METHODS: Pregnant women with hypertension were recruited and managed according to the departmental protocol. They were followed up till 6 weeks after delivery; fetal and maternal outcomes were documented. STATISTICAL ANALYSIS USED: Data were analyzed using the SPSS software version 23. The level of statistical significance was set at P < 0.05. RESULTS: A total of 1956 deliveries occurred during the study with 183 cases of HDP, giving an incidence of 9.4%. Pregnancy-induced hypertension alongside preeclampsia constitutes the majority of HDP during the study and had accounted for over 64%. Women who did not receive antenatal care in our center were at significantly greater risk of eclampsia (P = 0.000), abruption placentae (P = 0.003), maternal death (P = 0.002), very low-birth-weight (LBW) babies (P = 0.002), extremely LBW babies (P = 0.03), and perinatal death (P = 0.000). CONCLUSION: The need for prenatal screening that enables the early identification and prompt management of all expectant mothers with HDP is advised.