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