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评估沙库巴曲缬沙坦对心力衰竭患者舒张功能的影响:系统评价和荟萃分析。

Evaluating the impact of Sacubitril/valsartan on diastolic function in patients with heart failure: A systematic review and meta-analysis.

机构信息

Department of Internal Medicine III, Fujian Dehua County Hospital, Quanzhou, Fujian Province, China.

Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.

出版信息

Medicine (Baltimore). 2024 May 10;103(19):e37965. doi: 10.1097/MD.0000000000037965.

Abstract

BACKGROUND

Heart failure is a common and severe condition, often complicated by diastolic dysfunction. Current standard therapies such as ACEIs and ARBs have limited efficacy in managing diastolic function. Sacubitril/Valsartan, an emerging therapy, warrants rigorous investigation to elucidate its impact on diastolic function in heart failure patients.

METHODS

This systematic review and meta-analysis were conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and utilized the PICO schema. Searches were performed on 4 databases-PubMed, Embase, Web of Science, and Cochrane Library-without temporal restrictions. Inclusion and exclusion criteria were strictly defined, and quality assessments were conducted using the Cochrane Collaboration Risk of Bias tool. Both fixed-effects and random-effects models were used for statistical analysis, depending on inter-study heterogeneity assessed by I2 statistics and Chi-square tests.

RESULTS

Out of 1129 identified publications, 8 studies met the criteria and were included in the meta-analysis. These studies consisted of both randomized controlled trials and cohort studies and featured diverse global populations. Significant reductions were found in the echocardiographic parameter E/e' ratio and LAVi upon treatment with Sacubitril/Valsartan compared to standard therapies, with mean differences of -1.38 and -4.62, respectively, both with P values < .01.

CONCLUSIONS

This meta-analysis demonstrates that Sacubitril/Valsartan significantly improves diastolic function parameters in heart failure patients compared to standard treatments. These findings underscore the potential benefits of Sacubitril/Valsartan in the management of heart failure, particularly for patients with diastolic dysfunction.

摘要

背景

心力衰竭是一种常见且严重的病症,常伴有舒张功能障碍。目前的标准治疗方法,如 ACEI 和 ARB,在舒张功能管理方面疗效有限。沙库巴曲缬沙坦是一种新兴的治疗方法,需要进行严格的研究,以阐明其对心力衰竭患者舒张功能的影响。

方法

本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目,并使用 PICO 方案。在没有时间限制的情况下,在 4 个数据库(PubMed、Embase、Web of Science 和 Cochrane Library)上进行了搜索。严格定义了纳入和排除标准,并使用 Cochrane 协作风险偏倚工具进行了质量评估。根据 I2 统计量和卡方检验评估研究间的异质性,使用固定效应和随机效应模型进行统计分析。

结果

在 1129 篇已确定的出版物中,有 8 项研究符合标准并纳入荟萃分析。这些研究包括随机对照试验和队列研究,涉及不同的全球人群。与标准治疗相比,沙库巴曲缬沙坦治疗后超声心动图参数 E/e' 比值和 LAVi 显著降低,平均差异分别为-1.38 和-4.62,均 P 值<.01。

结论

这项荟萃分析表明,与标准治疗相比,沙库巴曲缬沙坦能显著改善心力衰竭患者的舒张功能参数。这些发现强调了沙库巴曲缬沙坦在心力衰竭管理中的潜在益处,特别是对舒张功能障碍的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd69/11081558/1e76f8b763be/medi-103-e37965-g001.jpg

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