Кардиоваскулярная терапия и профилактика (Apr 2025)
Cardiac contractility modulation in patients with heart failure with reduced ejection fraction: a meta-analysis of Russian clinical trials
Abstract
Aim. To perform a meta-analysis of Russian clinical trials and study the associations of cardiac contractility modulation in patients with heart failure with reduced left ventricular ejection fraction (LVEF).Material and methods. In the meta-analysis; the following outcome measures were selected: Minnesota Living With Heart Failure Questionnaire (MLWHFQ); 6-minute walk test (6MWT); improvement in heart failure functional class; echocardiography data: LVEF; LV end-systolic and end-diastolic volumes; as well as survival rates at 12 and 24 months.Results. The results included in the meta-analysis showed a significant improvement in the 6MWT distance (n=216) (mean difference -38;19; 95% confidence interval (CI): -65;46 to -10;91 m; p=0;006); MLWHFQ results (mean difference 7;28; 95% CI: 2;87-11;69; p=0;001); LVEF (mean difference -4;02; 95% CI: from -5;83 to 2;20; p<0;0001) and LV volume parameters (LV end-diastolic volume: mean difference 19;99; 95% CI: 7;56-32;42; p=0;002; LV end-systolic volume: mean difference 22;68; 95% CI: 12;85-32.51; p<0;001) after 24 months in the cardiac contractility modulation group compared to the control group. Survival was assessed after 12 and 24 months of follow-up — the differences were insignificant.Conclusion. The results of the data from 3 Russian clinical non-randomized studies included in the meta-analysis suggest that cardiac contractility modulation is associated with a significant improvement in quality of life; 6MWT distance; and reverse LV myocardial remodeling.
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