Khoufi Emad Ali Al
Internal Medicine Department, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Life (Basel). 2025 Jan 3;15(1):53. doi: 10.3390/life15010053.
Heart failure (HF) is a chronic condition that significantly affects morbidity and mortality. For patients with end-stage HF who are not candidates for heart transplantation, left ventricular assist devices (LVADs) provide mechanical circulatory support as a long-term solution, known as destination therapy (DT).
This meta-analysis aims to synthesize evidence on the survival rates, complications, and quality-of-life improvements associated with LVADs used as destination therapy in patients with end-stage HF.
A systematic search of databases, including PubMed, Embase, Cochrane Library, Web of Science, and Scopus, was conducted to identify relevant studies. Studies were selected based on predefined inclusion and exclusion criteria. Data from 12 studies were extracted and analyzed using a random-effects model. Survival rates, complications (e.g., infection and bleeding), and quality-of-life measures were the primary outcomes evaluated.
The analysis showed significant improvements in survival, with a pooled effect size of 0.848 (95% CI: 0.306-1.390, = 0.002). Complication rates varied, with infections and bleeding being the most common adverse events. Quality of life also improved significantly post-LVAD implantation, with a standardized mean difference of 0.78 (95% CI: 0.65-0.91).
LVADs as destination therapy provide a viable option for improving the survival and quality of life of end-stage HF patients, despite the associated risks of complications. Further research is needed to refine patient selection and management strategies to optimize outcomes.
心力衰竭（HF）是一种严重影响发病率和死亡率的慢性疾病。对于不适合心脏移植的终末期HF患者，左心室辅助装置（LVAD）可提供机械循环支持作为长期解决方案，即所谓的目标治疗（DT）。
本荟萃分析旨在综合有关LVAD用于终末期HF患者目标治疗的生存率、并发症及生活质量改善方面的证据。
对包括PubMed、Embase、Cochrane图书馆、科学网和Scopus在内的数据库进行系统检索，以识别相关研究。根据预先确定的纳入和排除标准选择研究。从12项研究中提取数据并使用随机效应模型进行分析。评估的主要结局为生存率、并发症（如感染和出血）及生活质量指标。
分析显示生存率有显著改善，合并效应量为0.848（95%CI：0.306 - 1.390，P = 0.002）。并发症发生率各不相同，感染和出血是最常见的不良事件。LVAD植入术后生活质量也有显著改善，标准化平均差为0.78（95%CI：0.65 - 0.91）。
尽管存在并发症相关风险，但LVAD作为目标治疗为改善终末期HF患者的生存率和生活质量提供了一个可行的选择。需要进一步研究以优化患者选择和管理策略，从而优化治疗效果。
