Abstract：
OBJECTIVE: To conduct an updated systematic review and meta-analysis to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) with regard to cardiac function and structure in people with or without type 2 diabetes mellitus (T2DM).
METHODS: We conducted a systematic search using the PubMed, Embase and ClinicalTrials.gov online databases. The primary outcome of interest was changes in mitral inflow E-velocity to tissue Doppler e\' velocity (E/e\') ratio. Secondary outcomes included other indicators of cardiac reverse remodelling and functional capacity comprising changes in left ventricular mass (LVM), left ventricular global longitudinal strain, left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction (LVEF), early to atrial mitral inflow velocity ratio, left atrial volume (LAV), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and 6-min walk test (6MWT) results.
RESULTS: A total of 15 trials involving 898 patients were included in this analysis. GLP-1RAs significantly improved E/e\' ratio (mean difference [MD] = -0.73; 95% confidence interval [CI] -1.34, -0.13), LVM (MD = -3.86 g; 95% CI -7.60, -0.12), LAV (MD = -8.20 mL; 95% CI -12.37, -4.04), NT-proBNP level (standardized MD = -0.27; 95% CI -0.47, -0.06), and 6MWT result (MD = +22.31 m; 95% CI 1.64, 42.99). However, GLP-1RAs had no effect on LVEF (MD = +0.31%; 95% CI -1.02, 1.64).
CONCLUSIONS: In this systematic review and meta-analysis, GLP-1RAs were found to have a positive impact on left ventricle diastolic function, hypertrophy, and exercise capacity, but had no effect on systolic function.
METHODS: We conducted a systematic search using the PubMed, Embase and ClinicalTrials.gov online databases. The primary outcome of interest was changes in mitral inflow E-velocity to tissue Doppler e\' velocity (E/e\') ratio. Secondary outcomes included other indicators of cardiac reverse remodelling and functional capacity comprising changes in left ventricular mass (LVM), left ventricular global longitudinal strain, left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction (LVEF), early to atrial mitral inflow velocity ratio, left atrial volume (LAV), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and 6-min walk test (6MWT) results.
RESULTS: A total of 15 trials involving 898 patients were included in this analysis. GLP-1RAs significantly improved E/e\' ratio (mean difference [MD] = -0.73; 95% confidence interval [CI] -1.34, -0.13), LVM (MD = -3.86 g; 95% CI -7.60, -0.12), LAV (MD = -8.20 mL; 95% CI -12.37, -4.04), NT-proBNP level (standardized MD = -0.27; 95% CI -0.47, -0.06), and 6MWT result (MD = +22.31 m; 95% CI 1.64, 42.99). However, GLP-1RAs had no effect on LVEF (MD = +0.31%; 95% CI -1.02, 1.64).
CONCLUSIONS: In this systematic review and meta-analysis, GLP-1RAs were found to have a positive impact on left ventricle diastolic function, hypertrophy, and exercise capacity, but had no effect on systolic function.
摘要：
目的：进行最新的系统综述和荟萃分析，以评估胰高血糖素样肽-1受体激动剂（GLP-1RAs）在患有或不患有2型糖尿病（T2DM）的人的心功能和结构方面的疗效。
方法：我们使用PubMed进行了系统的搜索，Embase和ClinicalTrials.gov在线数据库。感兴趣的主要结果是二尖瓣流入E速度与组织多普勒E'速度（E/e'）比的变化。次要结果包括心脏逆转重塑和功能容量的其他指标，包括左心室质量（LVM）的变化，左心室整体纵向应变，左心室舒张末期容积,左心室收缩末期容积,左心室射血分数(LVEF),早期与心房二尖瓣流入速度之比，左心房容积(LAV),N末端B型利钠肽前体（NT-proBNP）水平和6分钟步行试验（6MWT）结果。
结果：本分析共纳入15项试验，涉及898名患者。GLP-1RA显著提高E/e比值(平均差[MD]=-0.73;95%置信区间[CI]-1.34,-0.13),LVM（MD=-3.86g；95%CI-7.60，-0.12），LAV（MD=-8.20mL；95%CI-12.37，-4.04），NT-proBNP水平（标准化MD=-0.27；95%CI-0.47，-0.06），和6MWT结果（MD=+22.31m；95%CI1.64，42.99）。然而,GLP-1RA对LVEF无影响(MD=+0.31%;95%CI-1.02,1.64)。
结论：在本系统综述和荟萃分析中，发现GLP-1RA对左心室舒张功能有积极影响，肥大,和锻炼能力，但对收缩功能没有影响.
方法：我们使用PubMed进行了系统的搜索，Embase和ClinicalTrials.gov在线数据库。感兴趣的主要结果是二尖瓣流入E速度与组织多普勒E'速度（E/e'）比的变化。次要结果包括心脏逆转重塑和功能容量的其他指标，包括左心室质量（LVM）的变化，左心室整体纵向应变，左心室舒张末期容积,左心室收缩末期容积,左心室射血分数(LVEF),早期与心房二尖瓣流入速度之比，左心房容积(LAV),N末端B型利钠肽前体（NT-proBNP）水平和6分钟步行试验（6MWT）结果。
结果：本分析共纳入15项试验，涉及898名患者。GLP-1RA显著提高E/e比值(平均差[MD]=-0.73;95%置信区间[CI]-1.34,-0.13),LVM（MD=-3.86g；95%CI-7.60，-0.12），LAV（MD=-8.20mL；95%CI-12.37，-4.04），NT-proBNP水平（标准化MD=-0.27；95%CI-0.47，-0.06），和6MWT结果（MD=+22.31m；95%CI1.64，42.99）。然而,GLP-1RA对LVEF无影响(MD=+0.31%;95%CI-1.02,1.64)。
结论：在本系统综述和荟萃分析中，发现GLP-1RA对左心室舒张功能有积极影响，肥大,和锻炼能力，但对收缩功能没有影响.
