Echocardiographic observation on effect of Sacubitril/Valsartan on cardiac remodeling in patients with heart failure: Meta-analysis / 中国介入影像与治疗学

ABSTRACT

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%CI[0.86, 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.