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Effect of ghrelin on mortality and cardiovascular outcomes in experimental rat and mice models of heart failure: a systematic review and meta-analysis.

Khatib MN, Shankar A, Kirubakaran R, Agho K, Simkhada P, Gaidhane S, Saxena D, B U, Gode D, Gaidhane A, Zahiruddin SQ - PLoS ONE (2015)

Bottom Line: Studies have demonstrated various cardio-protective effects of Ghrelin.The meta-analysis revealed that the mortality in Ghrelin group was 31.1% and in control group was 40% (RR 0.83, 95% CI 0.46 to 1.47) i.e Ghrelin group had 68 fewer deaths per 1000 (from 216 fewer to 188 more) as compared to the control group.There were insignificant changes in cardiac output (SMD 0.28, 95% CI -0.24 to 0.80, P=0.29) and left ventricular end systolic pressure (MD 1.48, 95% CI -3.86 to 6.82, P=0.59).

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra State, India.

ABSTRACT

Background: Heart failure (HF) continues to be a challenging condition in terms of prevention and management of the disease. Studies have demonstrated various cardio-protective effects of Ghrelin. The aim of the study is to determine the effect of Ghrelin on mortality and cardiac function in experimental rats/mice models of HF.

Methods: Data sources: PUBMED, Scopus. We searched the Digital Dissertations and conference proceedings on Web of Science. Search methods: We systematically searched for all controlled trials (upto November 2014) which assessed the effects of Ghrelin (irrespective of dose, form, frequency, duration and route of administration) on mortality and cardiac function in rats/ mice models of HF. Ghrelin administration irrespective of dose, form, frequency, duration and route of administration. Data collection and analysis: Two authors independently assessed each abstract for eligibility and extracted data on characteristics of the experimental model used, intervention and outcome measures. We assessed the methodological quality by SYRCLE's risk of bias tool for all studies and the quality of evidence by GRADEpro. We performed meta-analysis using RevMan 5.3.

Results: A total of 325 animals (rats and mice) were analyzed across seven studies. The meta-analysis revealed that the mortality in Ghrelin group was 31.1% and in control group was 40% (RR 0.83, 95% CI 0.46 to 1.47) i.e Ghrelin group had 68 fewer deaths per 1000 (from 216 fewer to 188 more) as compared to the control group. The meta-analysis reveals that the heart rate in rats/mice on Ghrelin was higher (MD 13.11, 95% CI 1.14 to 25.08, P=0.66) while the mean arterial blood pressure (MD -1.38, 95% CI -5.16 to 2.41, P=0.48) and left ventricular end diastolic pressure (MD -2.45, 95% CI -4.46 to -0.43, P=0.02) were lower as compared to the those on placebo. There were insignificant changes in cardiac output (SMD 0.28, 95% CI -0.24 to 0.80, P=0.29) and left ventricular end systolic pressure (MD 1.48, 95% CI -3.86 to 6.82, P=0.59).

Conclusions: The existing data provides evidence to suggest that Ghrelin may lower the risk of mortality and improve cardiovascular outcomes. However; the quality of evidence as assessed by GRADEpro is low to very low. Clinical judgments to administer Ghrelin to patients with HF must be made on better designed animal studies.

No MeSH data available.


Related in: MedlinePlus

SYRCLE's Risk of bias summary: review authors' judgements about each risk of bias item for each included study [31,50,51,52,53,54,55].
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pone.0126697.g002: SYRCLE's Risk of bias summary: review authors' judgements about each risk of bias item for each included study [31,50,51,52,53,54,55].

Mentions: Risk of bias in included studies: The risk of bias in the included studies was assessed with the SYRCLE tool for assessing risk of bias in animal studies [40]. Risks of bias in different domains for each included study is summarized in Fig 2 and each risk of bias item is presented as percentages across all included studies in Fig 3. The studies were at low risk bias for baseline characteristics, incomplete outcome data and selective reporting. Details of allocation concealment, random housing conditions, blinding of the care-giver/ investigator/ outcome assessor and random outcome assessment were poorly described across majority of the studies[40]. Assessment of baseline characteristics between the experimental and control groups did not reveal any significant difference (by p-value).


Effect of ghrelin on mortality and cardiovascular outcomes in experimental rat and mice models of heart failure: a systematic review and meta-analysis.

Khatib MN, Shankar A, Kirubakaran R, Agho K, Simkhada P, Gaidhane S, Saxena D, B U, Gode D, Gaidhane A, Zahiruddin SQ - PLoS ONE (2015)

SYRCLE's Risk of bias summary: review authors' judgements about each risk of bias item for each included study [31,50,51,52,53,54,55].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4446297&req=5

pone.0126697.g002: SYRCLE's Risk of bias summary: review authors' judgements about each risk of bias item for each included study [31,50,51,52,53,54,55].
Mentions: Risk of bias in included studies: The risk of bias in the included studies was assessed with the SYRCLE tool for assessing risk of bias in animal studies [40]. Risks of bias in different domains for each included study is summarized in Fig 2 and each risk of bias item is presented as percentages across all included studies in Fig 3. The studies were at low risk bias for baseline characteristics, incomplete outcome data and selective reporting. Details of allocation concealment, random housing conditions, blinding of the care-giver/ investigator/ outcome assessor and random outcome assessment were poorly described across majority of the studies[40]. Assessment of baseline characteristics between the experimental and control groups did not reveal any significant difference (by p-value).

Bottom Line: Studies have demonstrated various cardio-protective effects of Ghrelin.The meta-analysis revealed that the mortality in Ghrelin group was 31.1% and in control group was 40% (RR 0.83, 95% CI 0.46 to 1.47) i.e Ghrelin group had 68 fewer deaths per 1000 (from 216 fewer to 188 more) as compared to the control group.There were insignificant changes in cardiac output (SMD 0.28, 95% CI -0.24 to 0.80, P=0.29) and left ventricular end systolic pressure (MD 1.48, 95% CI -3.86 to 6.82, P=0.59).

View Article: PubMed Central - PubMed

Affiliation: Department of Physiology, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra State, India.

ABSTRACT

Background: Heart failure (HF) continues to be a challenging condition in terms of prevention and management of the disease. Studies have demonstrated various cardio-protective effects of Ghrelin. The aim of the study is to determine the effect of Ghrelin on mortality and cardiac function in experimental rats/mice models of HF.

Methods: Data sources: PUBMED, Scopus. We searched the Digital Dissertations and conference proceedings on Web of Science. Search methods: We systematically searched for all controlled trials (upto November 2014) which assessed the effects of Ghrelin (irrespective of dose, form, frequency, duration and route of administration) on mortality and cardiac function in rats/ mice models of HF. Ghrelin administration irrespective of dose, form, frequency, duration and route of administration. Data collection and analysis: Two authors independently assessed each abstract for eligibility and extracted data on characteristics of the experimental model used, intervention and outcome measures. We assessed the methodological quality by SYRCLE's risk of bias tool for all studies and the quality of evidence by GRADEpro. We performed meta-analysis using RevMan 5.3.

Results: A total of 325 animals (rats and mice) were analyzed across seven studies. The meta-analysis revealed that the mortality in Ghrelin group was 31.1% and in control group was 40% (RR 0.83, 95% CI 0.46 to 1.47) i.e Ghrelin group had 68 fewer deaths per 1000 (from 216 fewer to 188 more) as compared to the control group. The meta-analysis reveals that the heart rate in rats/mice on Ghrelin was higher (MD 13.11, 95% CI 1.14 to 25.08, P=0.66) while the mean arterial blood pressure (MD -1.38, 95% CI -5.16 to 2.41, P=0.48) and left ventricular end diastolic pressure (MD -2.45, 95% CI -4.46 to -0.43, P=0.02) were lower as compared to the those on placebo. There were insignificant changes in cardiac output (SMD 0.28, 95% CI -0.24 to 0.80, P=0.29) and left ventricular end systolic pressure (MD 1.48, 95% CI -3.86 to 6.82, P=0.59).

Conclusions: The existing data provides evidence to suggest that Ghrelin may lower the risk of mortality and improve cardiovascular outcomes. However; the quality of evidence as assessed by GRADEpro is low to very low. Clinical judgments to administer Ghrelin to patients with HF must be made on better designed animal studies.

No MeSH data available.


Related in: MedlinePlus