射频消融治疗肥厚型梗阻性心肌病的疗效与安全性：一项荟萃分析。
Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: a meta-analysis.
作者信息
Hashim Hashim Talib, Osama Muhammad, Khan Muhammad Haris, Khan Safeena, Rehman Nohela, Ghuraibawi Mohammedbaqer, Ali Muhammad Abdullah, Ur Rehman Wajeeh, Raja Hafsa Arshad Azam, Khan Zeeshan, Hassan Malak Bilal, Madhi Zaid Saad Abed
机构信息
College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq.
Internal Medicine Department, Khyber Medical College, Peshawar, Pakistan.
出版信息
Future Cardiol. 2025 Jun;21(8):611-619. doi: 10.1080/14796678.2025.2509368. Epub 2025 May 22.
BACKGROUND
Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic heart disease leading to obstructive hypertrophy. Radiofrequency ablation (RFA) is a minimally invasive alternative to traditional treatments. This review evaluates RFA's effectiveness and safety for HOCM.
METHODS
A systematic review and meta-analysis were performed on studies from PubMed, Cochrane, and clinicaltrials.gov up to August 2024. Studies comparing RFA outcomes before and after the procedure were included. Data were analyzed through Revman software, using random-effects models. The funnel plots and Egger test were used for publication bias. Subgroup analysis and sensitivity analysis were also performed.
RESULTS
This meta-analysis included 16 cohort studies and 2 case series, encompassing 727 patients with ages ranging from 10.4 to 62 years. The studies were conducted in various countries, including China, the USA, Germany, the UK, India, and Brazil. The analysis revealed significant improvements following radiofrequency ablation (RFA): the LVOT gradient at rest was reduced by MD -58.2 (CI: -71.2 to -56.93, < 0.00001), and the provoked gradient decreased by MD -81.05 (CI: -97.67 to -64.42, < 0.00001).
CONCLUSION
RFA effectively reduces both LVOT gradients at rest and provoked, improves NYHA functional class, and decreases septal size in HOCM patients.
背景
肥厚型梗阻性心肌病（HOCM）是一种导致梗阻性肥厚的遗传性心脏病。射频消融术（RFA）是传统治疗方法的一种微创替代方案。本综述评估了RFA治疗HOCM的有效性和安全性。
方法
对截至2024年8月来自PubMed、Cochrane和clinicaltrials.gov的研究进行系统综述和荟萃分析。纳入比较手术前后RFA结果的研究。使用Revman软件通过随机效应模型分析数据。采用漏斗图和Egger检验评估发表偏倚。还进行了亚组分析和敏感性分析。
结果
该荟萃分析纳入了16项队列研究和2个病例系列，涵盖727例年龄在10.4至62岁之间的患者。这些研究在包括中国、美国、德国、英国、印度和巴西在内的多个国家进行。分析显示射频消融（RFA）后有显著改善：静息时左心室流出道梯度降低MD -58.2（CI：-71.2至-56.93，<0.00001），激发梯度降低MD -81.05（CI：-97.67至-64.42，<0.00001）。
结论
RFA可有效降低HOCM患者静息和激发状态下的左心室流出道梯度，改善纽约心脏协会（NYHA）心功能分级，并减小室间隔尺寸。
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