Effect of angiotensin converting enzyme inhibitor or angiotensin Ⅱ receptor blocker on right ventricular structure and function in transposition of great arteries with intra-atrial baffle: a meta-analysis

doi:10.3969/j.issn.1004-583X.2016.03.019

Abstract

Abstract: Objective To evaluate and analyze the effect of angiotensin converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist on right ventricular structure and function in transposition of the great arteries with intra-atrial baffle.Methods A comprehensive search was conducted up until 2015 in the following databases: PubMed, Cochrane Library, Embase, Web of Science, CBM, CNKI, VIP and WanFang Database. Studies assessing the multi-center, randomized, controlled, double-blind trials (RCT) of the right ventricular structure and function in transposition of the great arteries with intra-atrial baffle treated with angiotensin Ⅱ receptor antagonist or angiotensin converting enzyme inhibitor were included. The articles in reference lists were also reviewed. Four reviewers screened literature, extracted data, and assessed quality of included studies according to the inclusion and exclusion criteria, independently. Meta-analysis was performed using RevMan 5.2 software and CONSORT statement was applicated to comprehensively evaluate the report quality included in RCT literature.Results A total of 8 studies were finally included involving 3 randomized controlled trials, 4 randomized crossover trials, 1 controlled trial and in total 225 patients. Meta analysis showed that, there was no significant difference in right ventrieular ejection fraction (RVEF) compared with the placebo (MD=-0.69, 95%CI=-16.55-5.75,P=0.64), right ventricular end-diastolic volume (RVEDV) (MD=0.67, 95%CI=-29.68-31.02,P=0.97), right ventricular end-systolic volume (RVESV) (MD=2.28, 95%CI=-17.77-22.33,P=0.82), systolic blood pressure (SBP) (MD=-2.92, 95%CI=-7.92-2.08,P=0.25), maximal oxygen uptake (VO_2max) (MD=-0.14, 95%CI=-1.85-1.58,P=0.88), serum potassium (MD=0.11, 95%CI=-0.01-0.24,P=0.07), creatinine(Cr) (MD=0.87,95%CI=-4.25-5.98,P=0.74), heart rate (HR) (MD=-1.26, 95%CI=-3.06-0.54,P=0.17) or HRmax (MD=-3.35, 95%CI=-12.95-6.25,P=0.49) between ACEI or ARB.Conclusion Current evidence demonstrated that there were no significant difference in RVEF, RVEDV, RVESV, VO_2max, HR, HRmax, serum potassium and Cr in transposition of the great arteries with intra-atrial baffle treated with angiotensin converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist compared with placebo. There was significant difference in reducing the incidence of adverse cardiac events,however there were no significance in adverse reactions and higher safety.

Key words: heart defects, congenital, angiotensin-converting enzyme inhibitors, angiotensin Ⅱ type 2 receptor blockers, meta-analysis

CLC Number:

R541.1

Chen Junhui, Su Peng, Liu Shurao, Gao Xia,Song Pan, Yang Jianping. Effect of angiotensin converting enzyme inhibitor or angiotensin Ⅱ receptor blocker on right ventricular structure and function in transposition of great arteries with intra-atrial baffle: a meta-analysis[J]. Clinical Focus, 2016, 31(3): 307-314.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2016.03.019

https://huicui.hebmu.edu.cn/EN/Y2016/V31/I3/307

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