摘要
目的探讨心肌收缩力调节器(CCM)对心力衰竭患者的有效性。方法检索2001年1月到2022年3月的万方数据知识服务平台、知网、维普网、Cochrane图书馆、MEDLINE和EMBASE等数据库,以确定符合条件的临床研究,对其进行系统评价及荟萃分析。主要终点是全因死亡率、全因住院率、心力衰竭住院率、峰值耗氧量、6 min步行距离、生活质量评分和心律失常发生率。结果共纳入6项试验,其中4项为随机对照研究,共招募了935例患者。分析表明,与对照组相比CCM未能改善全因死亡率、全因住院率、心力衰竭住院率和心律失常发生率,但显著改善了峰值耗氧量[均数差(MD)=0.93,95%CI 0.56~1.31,P<0.001),6 min步行距离(MD=20.36,95%CI 6.06~34.66,P=0.005)和通过明尼苏达心力衰竭生活问卷(MLWHFQ)测量的生活质量(MD=-7.85,95%CI-10.76~-4.94,P<0.001)。结论CCM未能改善心力衰竭患者死亡率和住院率,但显著改善患者的生活质量。
Objective To investigate the effectiveness of cardiac contractility modulation(CCM)in patients with heart failure.Methods We searched Wanfang,CNKI,VIP,Cochrane Trial Center,MEDLINE,and EMBASE from January 2001 to March 2022 to identify eligible clinical studies,which were systematically reviewed and meta-analysed.The primary endpoints were all-cause mortality,all-cause hospitalizations,heart failure hospitalizations,peak oxygen consumption,6-minute walk test distance,quality of life scores,and incidence of arrhythmias.Results A total of six trials were included,of which 4 were randomized controlled studies,recruiting a total of 935 patients.The analysis showed that CCM failed to improve all-cause mortality,all-cause hospitalizations,heart failure hospitalizations,and arrhythmias compared with controls,but significantly improved peak oxygen consumption[mean difference(MD)=0.93,95%CI 0.56-1.31,P<0.001],6-minute walk test distance(MD=20.36,95%CI 6.06-34.66,P=0.005)and quality of life as measured by Minnesota living with heart failure questionnaire(MLWHFQ,MD=-7.85,95%CI-10.76--4.94,P<0.001).Conclusion CCM failed to improve mortality and hospitalization in heart failure patients,but significantly improved patients′quality of life.
作者
董震宇
芦颜美
李耀东
周贤惠
汤宝鹏
Dong Zhenyu;Lu Yanmei;Li Yaodong;Zhou Xianhui;Tang Baopeng(Department of Pacing and Electrophysiology,Department of Cardiac Electrophysiology and Remodeling,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054)
出处
《中华心律失常学杂志》
2022年第6期534-539,共6页
Chinese Journal of Cardiac Arrhythmias
基金
国家重点研发计划(2016YFC0900905)。
关键词
心力衰竭
心肌收缩力调节器
荟萃分析
Heart failure
Cardiac contractility modulation
Meta-analysis
