Effect of supplementing Qi and promoting blood circulation therapy on left ventricular remodeling: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness of an adjuvant therapy from Traditional Chinese Medicine for supplementing Qi and promoting blood circulation(CMSQPBC) on left ventricular remodeling in patients after myocardial infarction(MI).METHODS: Randomized controlled trials were identified in the Cochrane Library, Embase, Web of Science, PubMed, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang databases, reviews, and reference lists of relevant articles. The weighted mean difference(WMD) was calculated for changes in the left ventricular ejection fraction(LVEF), LV end-diastolic volume(LVEDV) and LV end-systolic volume(LVESV) from baseline to follow-up(> 3 months) by using random-effects Meta-analysis. The primary outcome was change in LVEF, and secondary outcomes were changes in LV dimensions including LVEDV and LVESV.RESULTS: A total of 10 trials(enrolling 854 participants, median follow-up six months) evaluated the association between CMSQPBC and changes in LV function and volume. Compared with the control group, CMSQPBC significantly improved LVEF(854 patients;WMD: 4.97%, 95% CI: 3.78-6.15;P < 0.001)and attenuated the enlargement of LVEDV(607 patients;WMD:-7.89 mL, 95% CI:-11.54 to-4.24;P<0.001) and LVESV(364 patients;WMD =-5.80 mL,95% CI,-9.60 to-2.01;P < 0.01).CONCLUSION: CMSQPBC may reverse deleterious pathological remodeling after myocardial infarction. Higher quality and more rigorous randomized trials with larger sample sizes are needed to further confirm the findings.