Effect of pueraria on left ventricular remodelling in HFrEF: A systematic review and meta-analysis

作者全名："Shi, Lipeng; Huang, Lumei; Yin, Erqian; Deng, Jingwei; Du, Xuqin"

作者地址："[Shi, Lipeng; Deng, Jingwei] Chongqing Med Univ, Coll Tradit Chinese Med, Chongqing, Peoples R China; [Huang, Lumei] Tradit Chinese Med Hosp Dianjiang Chongqing, Dept Cardiovasc UnitUnit, Chongqing, Peoples R China; [Yin, Erqian; Du, Xuqin] Chongqing Coll Tradit Chinese Med, Chongqing, Peoples R China; [Du, Xuqin] Chongqing Tradit Chinese Med Hosp, Chongqing, Peoples R China"

通信作者："Du, XQ (通讯作者)，Chongqing Coll Tradit Chinese Med, Chongqing, Peoples R China.; Du, XQ (通讯作者)，Chongqing Tradit Chinese Med Hosp, Chongqing, Peoples R China."

来源：PLOS ONE

ESI学科分类：Multidisciplinary

WOS号：WOS:001123190300002

JCR分区：Q1

影响因子：2.9

年份：2023

卷号：18

期号：12

开始页：　

结束页：　

文献类型：Review

关键词：　

摘要："BackgroundHeart failure with reduced ejection fraction (HFrEF) is a prevalent cardiovascular disease globally, posing a significant burden on healthcare and society. Left ventricular remodelling is the primary pathology responsible for HFrEF development and progression, leading to increased morbidity and mortality. Pueraria, a traditional Chinese herbal medicine and food, is commonly used in China to treat HFrEF. Accumulating evidence suggests that pueraria can effectively reverse left ventricular remodelling in HFrEF patients. This meta-analysis aims to assess the impact of pueraria on left ventricular remodelling in HFrEF patients.MethodsEight electronic databases, including PubMed, EMBASE, Clinicaltrials.gov, Cochrane Library, Wanfang, CNKI, CQVIP, and CBM were searched for literature from inception to June 2023. All randomized controlled trials (RCTs) using pueraria in the treatment of HFrEF were included. The Cochrane Risk of Bias tool was utilized for RCTs' methodological evaluation, while Review Manager 5.4.1 was used to analyze the data.ResultsNineteen RCTs with a total of 1,911 patients (1,077 males and 834 females) were identified. Meta-analysis indicated that combination medication of pueraria and conventional medicine (CM) was superior to the CM alone in raising left ventricular ejection fraction (LVEF; MD = 6.46, 95% CI, 4.88 to 8.04, P < 0.00001), and decreasing left ventricular end-diastolic diameter (LVEDD; MD = -4.78, 95% CI, -6.55 to -3.01, P < 0.00001), left ventricular end-Systolic diameter (LVESD; MD = -3.98, 95% CI, -5.98 to -1.99, P < 0.00001) and N-terminal pro-brain natriuretic peptide (NT-proBNP; MD = -126.16, 95% CI, -185.30 to -67.03, P < 0.0001). Besides, combination medication improved clinical efficacy rate (RR = 3.42, 95% CI, 2.54 to 4.59, P < 0.00001), 6-min walk test (6-MWT; MD = 65.54, 95% CI, 41.77 to 89.31, P < 0.00001), and TCM syndrome score efficacy (RR = 3.03, 95% CI, 1.57 to 5.83, P = 0.0009). Regarding safety, no difference was observed for adverse events (RR = 0.59, 95% CI, 0.22 to 1.54, P = 0.28).ConclusionThe use of pueraria combined with conventional medicine in HFrEF patients has superiority over conventional medicine alone in ameliorating cardiac function and reversing left ventricular remodeling. Moreover, combination medication has no increase in adverse drug events. Given some limitations, more prudence and high-quality clinical trials are needed in the future to verify the conclusions."

基金机构：Natural Science Foundation of Chongqing [cstc2021jcyj-bshX0215]; Science and Technology Research Program of Chongqing Municipal Education Commission [KJQN202315105]; Xinglin program of Chongqing TCM/TCM-integrated Key discipline [2021-ZDXK-DB03]

基金资助正文："This work was supported by the Natural Science Foundation of Chongqing (No. cstc2021jcyj-bshX0215), the Science and Technology Research Program of Chongqing Municipal Education Commission (No. KJQN202315105), and Xinglin program of Chongqing TCM/TCM-integrated Key discipline (No. 2021-ZDXK-DB03). The funders had role in study design, data collection and analysis, decision to publish, and preparation of the manuscript. The authors have no conflicts of interest to declare."