未经证实:尽管射血分数保留的心力衰竭(HFpEF)是一种严重的疾病,只有有限的选择可用于其治疗。最近的研究分析了磷酸二酯酶(PDE)抑制剂的作用,特别是PDE5和PDE3抑制剂,在HFpEF患者中,结果好坏参半。
UNASSIGNED:我们搜索了截至2021年8月的PUBMED和EMBASE数据库。纳入随机对照试验(RCT)和临床试验,测试PDE抑制剂对HFpEF患者的影响作为合格的研究。左心室(LV)功能指标,肺动脉压(PAP),右心室(RV)功能,锻炼能力,和生活质量(QOL)用于评估PDE抑制剂在HFpEF中的疗效。
UNASSIGNED:纳入了7项研究报告的6项RCT,以评估PDE抑制剂对HFpEF患者的疗效。在汇总分析中,PDE抑制剂显示早期舒张二尖瓣流入与环速度之比无明显变化,左心房容积指数,肺动脉收缩压(PASP),肺血管阻力(PVR),峰值摄氧量,6分钟步行测试距离,以及堪萨斯城心肌病问卷评分。然而,三尖瓣环平面收缩期偏移(TAPSE)显著改善.此外,回归分析显示,PDE抑制剂给药时间是PASP降低的关键因素。
UNASSIGNED:PDE抑制剂未有效改善LV功能,PAP,锻炼能力,HFpEF患者的生活质量。然而,它们改善了RV功能,差异显著,提示PDE抑制剂可能是有RV功能障碍的HFpEF患者的有希望的选择。
UNASSIGNED: Although heart failure with preserved ejection fraction (HFpEF) is a serious disease, only limited options are available for its treatment. Recent studies have analyzed the effects of phosphodiesterase (PDE) inhibitors, especially PDE5 and PDE3 inhibitors, in patients with HFpEF, with mixed outcomes.
UNASSIGNED: We searched PUBMED and EMBASE databases up to August 2021. Randomized controlled trials (RCTs) and clinical trials that tested the effects of PDE inhibitors on patients with HFpEF were included as eligible studies. Indicators of left ventricular (LV) function, pulmonary arterial pressure (PAP), right ventricular (RV) function, exercise capacity, and quality of life (QOL) were used to evaluate the efficacy of PDE inhibitors in HFpEF.
UNASSIGNED: Six RCTs that reported in 7 studies were included to evaluate the efficiency of PDE inhibitors on HFpEF patients. In the pooled analysis, PDE inhibitors showed insignificant changes in the ratio of early diastolic mitral inflow to annular velocities, left atrial volume index, pulmonary artery systolic pressure (PASP), pulmonary vascular resistance (PVR), peak oxygen uptake, 6-minute walking test distance, as well as Kansas City Cardiomyopathy Questionnaire score. However, substantial improvement was observed in the tricuspid annular plane systolic excursion (TAPSE). Additionally, the regression analysis showed that PDE inhibitor administration time is a critical factor for the decrease in PASP.
UNASSIGNED: PDE inhibitors did not effectively improve LV function, PAP, exercise capacity, and QOL in patients with HFpEF. However, they improved RV function with significant difference, suggesting that PDE inhibitors might be a promising option for HFpEF patients with RV dysfunction.