Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Otorhinolaryngology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China.
BMJ Open. 2024 Sep 10;14(9):e088744. doi: 10.1136/bmjopen-2024-088744.
Heart failure (HF) is a complex syndrome that affects millions of people worldwide and leads to significant morbidity and mortality. Sacubitril/valsartan, a combination drug consisting of a neprilysin inhibitor and an angiotensin receptor blocker (ARB), has shown a greater improvement in the prognosis of HF than ACE inhibitors (ACEI) or ARB. Recent studies have found that ACEI/ARB or sacubitril/valsartan can increase flow-mediated dilation (FMD) and reduce pulse wave velocity (PWV), which are independent predictors of cardiovascular events and HF prognosis. The purpose of this study is to assess and compare the effect of sacubitril/valsartan and ACEI/ARB on FMD and PWV using meta-analysis and further provide a reference for the role of sacubitril/valsartan in the treatment of HF.
Clinical randomised controlled trials investigating the effect of sacubitril/valsartan and/or ACEI/ARB on FMD and PWV in patients with HF will be searched in the relevant database, including PubMed, Web of Science, Embase, Cochrane Library and China's National Knowledge Infrastructure up to January 2024. The outcomes of interest are changes in endothelial function assessed by FMD and changes in arterial stiffness assessed by PWV. The risk of bias was evaluated using the revised Cochrane risk of bias tool for randomised trials (RoB2.0). Review Manager V.5.3 software is used for meta-analysis data synthesis, sensitivity analysis, meta-regression analysis, subgroup analysis and risk of bias assessment. The reporting bias of studies will be evaluated using the funnel plot, in which symmetry will be assessed by Begg's and Egger's tests. The evidence quality of the included studies will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation.
This study only analyses research data from the published literature and therefore does not require ethical approval. We will submit the systematic review to a peer-reviewed journal.
CRD42024538148.
心力衰竭（HF）是一种复杂的综合征，影响着全球数百万人，导致发病率和死亡率显著增加。沙库巴曲缬沙坦是一种由脑啡肽酶抑制剂和血管紧张素受体拮抗剂（ARB）组成的复方药物，其在改善 HF 预后方面的效果优于血管紧张素转换酶抑制剂（ACEI）或 ARB。最近的研究发现，ACEI/ARB 或沙库巴曲缬沙坦可增加血流介导的舒张功能（FMD）和降低脉搏波速度（PWV），这是心血管事件和 HF 预后的独立预测因子。本研究旨在通过荟萃分析评估和比较沙库巴曲缬沙坦和 ACEI/ARB 对 FMD 和 PWV 的影响，并进一步为沙库巴曲缬沙坦在 HF 治疗中的作用提供参考。
将在相关数据库中搜索有关沙库巴曲缬沙坦和/或 ACEI/ARB 对 HF 患者 FMD 和 PWV 影响的临床随机对照试验，包括 PubMed、Web of Science、Embase、Cochrane 图书馆和中国国家知识基础设施，截至 2024 年 1 月。感兴趣的结局是通过 FMD 评估内皮功能的变化和通过 PWV 评估动脉僵硬的变化。使用修订后的 Cochrane 随机试验偏倚风险工具（RoB2.0）评估偏倚风险。Review Manager V.5.3 软件用于荟萃分析数据合成、敏感性分析、meta 回归分析、亚组分析和偏倚风险评估。使用漏斗图评估研究的发表偏倚，使用 Begg 和 Egger 检验评估对称性。通过 Grading of Recommendations Assessment, Development, and Evaluation 评估纳入研究的证据质量。
本研究仅分析来自已发表文献的研究数据，因此不需要伦理批准。我们将把系统评价提交给同行评议的期刊。
PROSPERO 注册号：CRD42024538148。
