Abdelazeem Basel, Abbas Kirellos Said, Ahmad Soban, Raslan Hasan, Labieb Fatma, Savarapu Pramod
Internal Medicine, McLaren Health Care, Flint, MI 48532, USA.
Internal Medicine, Michigan State University, East Lansing, MI 48823, USA.
Rev Cardiovasc Med. 2022 Apr 12;23(4):141. doi: 10.31083/j.rcm2304141. eCollection 2022 Apr.
Angiotensin receptor blocker (ARB) therapy has been evaluated to slow down the disease progression in patients with hypertrophic cardiomyopathy (HCM), but there is scarce evidence available to date. Therefore, our meta-analysis aimed to explore the efficacy of ARB therapy as a potential disease-modifying treatment in patients with HCM.
A literature search was performed using PubMed, Scopus, Web of Science, Embase, Cochrane library, and Clinicaltrials.gov databases from inception to December 13th, 2021. We included only randomized controlled trials (RCTs). The quality of included studies was assessed by the Cochrane Collaboration's tool. Primary outcomes included the reduction in left ventricular mass and improvement in other echocardiographic features of myocardial dysfunction. The secondary outcome was a net reduction in systolic blood pressure. Meta-analysis was performed using pooled standardized mean difference (SMD) and corresponding 95% confidence interval (CI).
A total of 1286 articles were screened. Seven RCTs met the inclusion criteria representing a total of 397 patients with HCM (195 patients were in the ARB group). ARB treatment was associated with significant reduction in left ventricular mass (SMD: -0.77; 95% CI: -1.40, -0.03; = 0.04). ARB therapy was also associated with a significant reduction in systolic blood pressure (SMD: -0.33; 95% CI: -0.61, -0.05: = 0.02).
ARB therapy is associated with a marked reduction in left ventricular mass and systolic blood pressure in patients with hypertrophic cardiomyopathy. We recommend further studies with a larger patient population size to confirm the findings of our meta-analysis.
OSF Registries, DOI: 10.17605/OSF.IO/DAS7C.
血管紧张素受体阻滞剂（ARB）治疗已被评估用于减缓肥厚型心肌病（HCM）患者的疾病进展，但迄今为止证据稀少。因此，我们的荟萃分析旨在探讨ARB治疗作为HCM患者潜在疾病修饰治疗的疗效。
使用PubMed、Scopus、Web of Science、Embase、Cochrane图书馆和Clinicaltrials.gov数据库从创建至2021年12月13日进行文献检索。我们仅纳入随机对照试验（RCT）。纳入研究的质量通过Cochrane协作组织的工具进行评估。主要结局包括左心室质量的降低和心肌功能障碍其他超声心动图特征的改善。次要结局是收缩压的净降低。使用合并标准化均数差（SMD）和相应的95%置信区间（CI）进行荟萃分析。
共筛选了1286篇文章。七项RCT符合纳入标准，共纳入397例HCM患者（195例患者在ARB组）。ARB治疗与左心室质量显著降低相关（SMD：-0.77；95%CI：-1.40，-0.03；P = 0.04）。ARB治疗还与收缩压显著降低相关（SMD：-0.33；95%CI：-0.61，-0.05；P = 0.02）。
ARB治疗与肥厚型心肌病患者的左心室质量和收缩压显著降低相关。我们建议进行更大患者群体的进一步研究以证实我们荟萃分析的结果。
OSF注册库，DOI：10.17605/OSF.IO/DAS7C。
