National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
Diabetes Obes Metab. 2024 Jun;26(6):2401-2411. doi: 10.1111/dom.15557. Epub 2024 Mar 26.
To conduct an updated systematic review and meta-analysis to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) with regard to cardiac function and structure in people with or without type 2 diabetes mellitus (T2DM).
We conducted a systematic search using the PubMed, Embase and ClinicalTrials.gov online databases. The primary outcome of interest was changes in mitral inflow E-velocity to tissue Doppler e' velocity (E/e') ratio. Secondary outcomes included other indicators of cardiac reverse remodelling and functional capacity comprising changes in left ventricular mass (LVM), left ventricular global longitudinal strain, left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction (LVEF), early to atrial mitral inflow velocity ratio, left atrial volume (LAV), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and 6-min walk test (6MWT) results.
A total of 15 trials involving 898 patients were included in this analysis. GLP-1RAs significantly improved E/e' ratio (mean difference [MD] = -0.73; 95% confidence interval [CI] -1.34, -0.13), LVM (MD = -3.86 g; 95% CI -7.60, -0.12), LAV (MD = -8.20 mL; 95% CI -12.37, -4.04), NT-proBNP level (standardized MD = -0.27; 95% CI -0.47, -0.06), and 6MWT result (MD = +22.31 m; 95% CI 1.64, 42.99). However, GLP-1RAs had no effect on LVEF (MD = +0.31%; 95% CI -1.02, 1.64).
In this systematic review and meta-analysis, GLP-1RAs were found to have a positive impact on left ventricle diastolic function, hypertrophy, and exercise capacity, but had no effect on systolic function.
进行更新的系统评价和荟萃分析，以评估胰高血糖素样肽-1 受体激动剂（GLP-1RAs）在有或没有 2 型糖尿病（T2DM）的人群中心功能和结构的疗效。
我们使用 PubMed、Embase 和 ClinicalTrials.gov 在线数据库进行了系统搜索。主要观察结果是二尖瓣血流 E 速度与组织多普勒 e'速度（E/e'）比值的变化。次要观察结果包括其他心脏逆重构和功能能力的指标，包括左心室质量（LVM）、左心室整体纵向应变、左心室舒张末期容积、左心室收缩末期容积、左心室射血分数（LVEF）、早期到心房二尖瓣血流速度比、左心房容积（LAV）、N 末端 pro-B 型利钠肽（NT-proBNP）水平和 6 分钟步行试验（6MWT）结果的变化。
这项分析共纳入了 15 项涉及 898 名患者的试验。GLP-1RAs 显著改善了 E/e'比值（平均差异 [MD] = -0.73；95%置信区间 [CI] -1.34，-0.13）、LVM（MD = -3.86 g；95% CI -7.60，-0.12）、LAV（MD = -8.20 mL；95% CI -12.37，-4.04）、NT-proBNP 水平（标准化 MD = -0.27；95% CI -0.47，-0.06）和 6MWT 结果（MD = +22.31 m；95% CI 1.64，42.99）。然而，GLP-1RAs 对 LVEF 没有影响（MD = +0.31%；95% CI -1.02，1.64）。
在这项系统评价和荟萃分析中，发现 GLP-1RAs 对左心室舒张功能、肥厚和运动能力有积极影响，但对收缩功能没有影响。
