射血分数保留型心力衰竭随机对照试验的超声心动图结局指标研究

BackgroundThe selection of echocardiographic indexes for efficacy evaluation of heart failure with preserved ejection fractionHFpEFlacks a uniform standard. ObjectiveAnalyze the echocardiographic outcome measures in randomized controlled trialsRCTof HFpEF to provide a reference for the development of a standardized efficacy evaluation system for HFpEF. Methods PubMedEmbase and Cochrane Central Register of Controlled Trials were searched for RCT related to HFpEF from January 12021 to November 32023. Echocardiographic outcome measures and other information were extracted after literature screening according to eligibility criteria. The frequency and percentage of echocardiographic outcome measures were analyzed and an association rule analysis was conducted. ResultsA total of 825 literatures were obtained and 14 literatures were finally included after screening. A total of 39 echocardiographic outcome measures were used in 14 studies. The minimum number of echocardiographic outcome measures used in a single study was 2and the maximum was 18. The top 10 echocardiographic outcome measures in terms of usage frequency were ratio of mitral peak velocity of early fillingEto mitral peak velocity of late fillingAleft ventricular ejection fractionLVEFaverage ratio of E to early diastolic mitral annular velocitye'left atrial volume indexLAVIleft ventricular end-diastolic diameterLVEDDleft atrial diameterLADseptal E/e'left ventricular mass indexLVMIE deceleration timeEDTand tricuspid annular plane systolic excursionTAPSE. The association rule analysis showed that when different quantitative indicators were combinedthe rules with the highest support were respectively average E/e' LAVILVEF+E/A LVEDD and LAVI+average E/e'+LVEF LVEDD. ConclusionIn HFpEF RCTsthe commonly used echocardiographic outcome measures are E/ALVEFand average E/e'. MoreoverLAVI and LVEDD are often used in combination with the above indicators. Lack of consistencyrationalityrecognition and standardization are the problems of echocardiographic outcome measures selection in HFpEF RCTs. The development of a core outcome set may be an effective way to solve the above problems.