Favorable effects of vasodilators on left ventricular remodeling in asymptomatic patients with chronic moderate-severe aortic regurgitation and normal ejection fraction: a meta-analysis of clinical trials Full Text
Clinical Cardiology, 06/22/2012
Shah RM et al. – In asymptomatic patients with chronic severe aortic regurgitation (AR) and normal left ventricular (LV) function, vasodilators have favorable effects on LV remodeling.Methods
- Authors performed a systematic literature search for randomized clinical trials using long–term vasodilator therapy in asymptomatic patients with chronic severe AR and normal LV function.
- The magnitude of difference between the vasodilator and nonvasodilator groups was assessed by computing the mean difference (MD).
- Heterogeneity of the studies was analyzed by Cochran Q statistics.
- The MD for LV ejection fraction, LV end systolic volume index, and LV end diastolic volume index were computed by random effects model.
- The MD for LV end–systolic diameter and LV end–diastolic diameter were computed by fixed effects model.
- A 2–sided alpha error <0.05 was considered to be statistically significant.
- Seven studies with 460 patients were included.
- Meta–analysis of the studies revealed a significant increase in LVEF (MD: 5.32, 95% confidence interval [CI]: 0.37 to 10.26, P = 0.035), a significant decrease in LV end diastolic volume index (MD: –16.282, 95% CI: –23.684 to –8.881, P < 0.001), and a significant decrease in LV end diastolic diameter (MD: –2.343, 95% CI: –3.397 to –1.288, P < 0.001) in the vasodilator group compared with the nonvasodilator group. However, there was no significant decrease in LV end systolic volume index (MD: –6.105, 95% CI: –12.478 to 0.267, P = 0.060) or in LV end systolic diameter (MD: 0.00, 95% CI: –0.986 to 0.986, P = 1.0) in the vasodilator group compared with the nonvasodilator group.