射血分数降低的心力衰竭的压力反射激活疗法：一项全面的系统评价和荟萃分析。
Baroreflex activation therapy for heart failure with reduced ejection fraction: A comprehensive systematic review and meta-analysis.
作者信息
Shi Ruijie, Sun Tong, Wang Mengxi, Xiang Qian, Ding Yuhan, Yin Siyuan, Chen Yan, Shen Le, Yu Peng, Chen Xiaohu
机构信息
Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
出版信息
Heliyon. 2024 Jan 9;10(2):e24177. doi: 10.1016/j.heliyon.2024.e24177. eCollection 2024 Jan 30.
BACKGROUND
In recent years, baroreflex activation therapy (BAT) has been utilized to treat heart failure with reduced ejection fraction (HFrEF). However, the supporting literature on its efficacy and safety is still limited. This investigation elucidates the effects of BAT in HFrEF patients to provide a reference for future clinical applications.
METHODS
This investigation follows Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Relevant investigations on the use of BAT in HFrEF patients were searched and selected from 5 databases, including Web of Science, MEDLINE, PubMed, Embase, and Cochrane Library, from inception to December 2022. The methodological quality of eligible articles was assessed via the Cochrane risk of bias tool, and for meta-analysis, RevMan (5.3) was used.
RESULTS
Randomized controlled trials comprising 343 participants were selected for the meta-analysis, which revealed that in HFrEF patients, BAT enhanced the levels of LVEF (MD: 2.97, 95 % CI: 0.53 to 5.41), MLHFQ (MD: -14.81, 95 % CI: -19.57 to -10.06) and 6MWT (MD: 68.18, 95 % CI: 51.62 to 84.74), whereas reduced the levels of LVEDV (MD: -15.79, 95 % CI: -32.96 to 1.37) and DBP (MD: -2.43, 95 % CI: -4.18 to -0.68).
CONCLUSION
It was concluded that BAT is an efficient treatment option for HFrEF patients. However, to validate this investigation, further randomized clinical trials with multiple centers and large sample sizes are needed.
背景
近年来，压力反射激活疗法（BAT）已被用于治疗射血分数降低的心力衰竭（HFrEF）。然而，关于其疗效和安全性的支持性文献仍然有限。本研究阐明了BAT对HFrEF患者的影响，为未来的临床应用提供参考。
方法
本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）2020指南。从创刊至2022年12月，在包括Web of Science、MEDLINE、PubMed、Embase和Cochrane图书馆在内的5个数据库中检索并筛选关于在HFrEF患者中使用BAT的相关研究。通过Cochrane偏倚风险工具评估符合条件文章的方法学质量，并使用RevMan（5.3）进行Meta分析。
结果
选择了包含343名参与者的随机对照试验进行Meta分析，结果显示，在HFrEF患者中，BAT提高了左心室射血分数（LVEF）水平（MD：2.97，95%CI：0.53至5.41）、明尼苏达心力衰竭生活质量量表（MLHFQ）得分（MD：-14.81，95%CI：-19.57至-10.06）和6分钟步行试验（6MWT）距离（MD：68.18，95%CI：51.62至84.74），而降低了左心室舒张末期容积（LVEDV）水平（MD：-15.79，95%CI：-32.96至-）和舒张压（DBP）水平（MD：-2.43，95%CI：-4.18至-0.68）。
结论
得出的结论是，BAT是HFrEF患者的一种有效治疗选择。然而，为了验证本研究结果，需要进一步开展多中心、大样本量的随机临床试验。
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