肌球蛋白抑制剂对肥厚型心肌病疗效及安全性的Meta分析

Efficacy and safety of cardiac myosin inhibitor in hypertrophic cardiomyopathy:A meta analysis

目的:探讨肌球蛋白抑制剂(CMI)治疗肥厚型心肌病(HCM)的安全性和有效性。方法:在7个数据库中搜索了建库以来所有关于CMI治疗HCM的随机对照试验(RCTs),并将数据汇总分析,计算优势比及其95%置信区间(CI)。结果:共有6项RCTs(621名患者)被纳入。与接受HCM基础治疗相比,CMI可以使左心室射血分数(LVEF),二尖瓣左室舒张早期血流峰值速度/二尖瓣环根部舒张早期峰值速度(E/e′)、左心房容积指数(LAVi),达到室间隔缩小术(SRT)标准的人数、N-端B型利钠肽前体(NT-proBNP)和左心室流出道(LVOT)压差均显著降低,显著改善堪萨斯城心肌病问卷临床总评分(KCCQ-CSS)。结论:CMI可以抑制HCM患者的心肌过度收缩并且改善其舒张功能和预后。服用CMI与严重不良反应(SAE)无关。

Objective:To investigate the safety and efficacy of cardiac myosin inhibitors(CMI)in the treatment of hypertrophic cardiomyopathy(HCM).Methods:We searched for all randomized controlled trials(RCTs)about CMI for HCM in 7 databases.Data were pooled into a stratified meta-analysis and the odds ratio,and its corresponding 95%confidence interval(CI)were calculated.Results:A total of six RCTs(621 patients)were included.Compared with placebo,CMI decreased left ventricular ejection fraction(LVEF),E/e',left atrial volume index(LAVi),the number of patients who met septal reduction therapy(SRT)guidelines,NT-proBNP,and left ventricular outflow tract(LVOT).KCCQ-CSS was significantly improved.Conclusion:CMI could inhibit myocardial systolic function and improve diastolic function and prognosis in patients with HCM.The administration of CMI was not associated with serious adverse events.