Meta-analysis addressing the impact of cardiovascular-acting medication on peak oxygen uptake of patients with HFpEF

As our therapeutic armamentarium for HFpEF is insufficient, research has been focusing on the potential beneficial effect of existing pharmaceutical regimens on this specific patient population. A series of RCTs have recently examined the impact of various pharmaceutical treatments with proven benef...

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Bibliographic Details
Published in:Heart failure reviews 2022-03, Vol.27 (2), p.609-623
Main Authors: Boulmpou, Aristi, Theodorakopoulou, Marieta P., Alexandrou, Maria-Eleni, Boutou, Afroditi K., Papadopoulos, Christodoulos E., Pella, Eva, Sarafidis, Pantelis, Vassilikos, Vassilios
Format: Article
Language:English
Subjects:
Anaerobic threshold
Bias
Cardiology
Cardiorespiratory fitness
Cardiovascular Agents - therapeutic use
Ejection fraction
Exercise Tolerance
Heart Failure
Hospitals
Humans
Maximum oxygen consumption
Medicine
Medicine & Public Health
Meta-analysis
Oxygen
Patients
Pharmaceutical Preparations
Pharmaceuticals
Physical fitness
Spironolactone - therapeutic use
Statistical analysis
Stroke Volume
Systematic review
Ventricular Function, Left
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Summary:As our therapeutic armamentarium for HFpEF is insufficient, research has been focusing on the potential beneficial effect of existing pharmaceutical regimens on this specific patient population. A series of RCTs have recently examined the impact of various pharmaceutical treatments with proven benefit in HFrEF, on the improvement of symptoms of HFpEF patients. This systematic review and meta-analysis comprised studies of adult patients with HFpEF and evaluated the impact of different cardiovascular acting medication on cardiorespiratory fitness, reflected by peak VO 2 values measured during CPET. The primary outcome was difference between groups in the change of peak VO 2 (ΔpeakVO 2 ). Literature search involved PubMed/MEDLINE, Scopus and Web of Science databases. Our search identified 3634 records and 19 studies were included in qualitative analysis; 12 studies with 1341 patients were finally included in primary outcome analysis. ΔpeakVO 2 between baseline and study-end did not significantly change after treatment with spironolactone, ivabradine, sildenafil, or oral inorganic nitrate and neither did difference in 6MWT distance after treatment with spironolactone. Spironolactone led to statistically significant reduction in E/E’ ratio study-end values (WMD − 1.64, 95%CI − 2.42 to − 0.86, I 2  = 87%, p  
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-021-10207-5