超声心动图评估沙库巴曲缬沙坦对心力衰竭患者心脏重构的影响:Meta分析

目的采用Meta分析评价超声心动图评估沙库巴曲缬沙坦对心力衰竭(HF)患者心脏重构的影响。方法检索2020年1月31日前发表的随机对照试验(RCT),以加权均数差(WMD)和95%CI为合并统计量进行Meta分析。结果共纳入10项RCT、1 186例HF患者, 6项为低风险、3项为不确定、1项为高风险。沙库巴曲缬沙坦可显著提高HF患者左心室射血分数(LVEF)WMD=2.28,95%CI(0.86,3.70),P0.01],有效降低左心室舒张末期内径(LVEDD)WMD=-3.12, 95%CI(-4.51,-1.73),P0.01]、左心室收缩末期内径(LVESD)WMD=-2.43,95%CI(-3.96,-0.90),P0.01]、左心室质量指数(LVMI)WMD=-5.92,95%CI(-10.37,-1.47),P0.01]及室间隔厚度(IVST)WMD=-0.83,95%CI(-1.31,-0.35),P0.01],而对左心室舒张末期容积(LVEDV)WMD=-1.13,95%CI(-11.19,8.93),P=0.83]、左心室收缩末期容积(LVESV)WMD=-5.46,95%CI(-12.23,1.30),P=0.11]及左心房容积(LAV)WMD=-9.25,95%CI(-19.54,1.05),P=0.08]无显著影响。结论沙库巴曲缬沙坦可改善或逆转HF患者心脏重构。超声心动图可用于评估沙库巴曲缬沙坦对HF患者心脏重构的影响。

Echocardiographic observation on effect of Sacubitril/Valsartan on cardiac remodeling in patients with heart failure: Meta-analysis

Objective To observe the effect of Sacubitril/Valsartan on cardiac remodeling in patients with heart failure (HF) by using Meta-analysis of echocardiographic findings. Methods Randomized controlled trials (RCT) before Jan 31, 2020 were searched. Meta-analysis was performed using weighted mean difference (WMD) with 95%CI. Results Ten RCT with a total of 1 186 HF patients were enrolled, including 6 low risk, 3 unclear and 1 high risk studies. Sacubitril/Valsartan significantly improved the left ventricular ejection fraction (LVEF) (WMD=2.28, 95%CI0.86, 3.70], P<0.01), left ventricular end-diastolic dimension (LVEDD) (WMD=-3.12, 95%CI-4.51, -1.73], P<0.01), left ventricular end-systolic dimension (LVESD) (WMD=-2.43, 95%CI-3.96, -0.90], P<0.01), left ventricular mass index (LVMI) (WMD=-5.92, 95%CI-10.37, -1.47], P<0.01) and interventricular septum thickness (IVST) (WMD=-0.83, 95%CI-1.31, -0.35], P<0.01), while the left ventricular end-diastolic volume (LVEDV) (WMD=-1.13, 95%CI-11.19, 8.93], P=0.83), left ventricular end-systolic volume (LVESV) (WMD=-5.46, 95%CI-12.23, 1.30], P=0.11) and left atrial volume (LAV) (WMD=-9.25, 95%CI-19.54, 1.05], P=0.08) were not significantly affected. Conclusion Sacubitril/Valsartan can improve or reverse the cardiac remodeling of HF patients. Echocardiography can be used to evaluate the effects of Sacubitril/Valsartan on cardiac remodeling in patients with HF.