Sami Salahia
Ain Shams University, Egypt
Title: Efficacy and safety of the angiotensin II receptor blocker losartan for hypertrophic cardiomyopathy: Systematic review and meta-analysis
Biography
Biography: Sami Salahia
Abstract
Introduction: Hypertrophic Cardiomyopathy is an inherited disease caused by mutations that occur in B-myosin heavy chain that affects heart muscle proteins. It’s the most common cause of sudden cardiac arrest in Young Athletics. Angiotensin II receptor blockers (ARBs) such as Losartan is a medication that attenuate the myocardial hypertrophy and fibrosis.
Purpose: To systematically review and conduct a meta-analysis of randomized controlled trials investigating the impact of Losartan as Angiotensin receptor blocker on Hypertrophic Cardiomyopathy.
Methods: We searched PubMed, Medline, Scopus, Web of Science and ScienceDirect to detect randomized controlled trials that evaluate the impact of Losartan and ARBs on patients with Hypertrophic Cardiomyopathy.
Results: From a total of 694 entries identified, six RCTs were appropriate for inclusion into the final analysis. The metaanalysis indicated a significant lowering of Systolic blood pressure (mm Hg) compared to Placebo (MD= -7.16, 95% CI [-12.95, -1.36], p=0.02). While the pooled estimate showed no significant difference between Losartan and Placebo regarding Left atrial volume(MD= -5.71, 95% CI [-13.55, 2.14], p=0.15), Left ventricle outflow peak gradient(MD= 1.30, 95% CI [-4.69, 7.29], p=0.67), Left ventricular wall thickness(MD= -1.42, 95% CI [-6.32, 3.48], p=0.57), Left ventricle diastolic diameter (MD= 0.00, 95% CI [-7.10, 7.10], p=1.00), Diastolic blood pressure (MD= -1.00, 95% CI [-9.10, 7.10], p=0.81), NT-proBNP (MD= 7.00, 95% CI [2.04, 11.96], p=0.006). Regarding Tissue Doppler Ea (cm/s), Tissue Doppler Ea/Aa and E/E’ (lateral) The pooled estimate of studies did not differ significantly between the ARB and control group (MD= 2.03, 95% CI [-0.35, 4.42], p=0.09),(MD= 2.00, 95% CI [-0.30, 0.70], p=0.43), and E/E (MD= -2.60, 95% CI [-6.20, 0.99], p=0.16), respectively.
Conclusion: This meta-analysis showed a significant difference of lowering Systolic blood pressure (mm Hg) compared to Placebo while Losartan had no effect on improving the myocardial performance in patients with Hypertrophic Cardiomyopathy.
Recent Publications
1. Salahia S I, Safi O, El-sabbagh A E A, Ellotf H M, Fouda M A, Salahia S I, Ahmed M, et al (2017). PROSPERO International prospective register of systematic reviews Efficacy of tranexamic acid as compared to aprotinin undergoing cardiac surgery with cardiopulmonary bypass systematic review and meta-analysis.
2. Salahia S I, Saad A M, Hilali M F, Alkhaledi A N, Khalaf A R, and Khaled. (2017). A Long-term, T H PROSPERO International prospective register of systematic reviews Long-term versus short-term zoledronic acid for metastatic
breast cancer: a systematic review and meta-analysis.
3. Salahia S, Safi O, Saadeddin A, Mahmoud H, Al-husseini M, Sinokrot M, Al-husseini M et al (2017). PROSPERO International prospective register of systematic reviews Systematic review and meta-analysis of systemic infammatory response syndrome after pediatric congenital heart surgery.
4. Salahia S, Salahia H, Saad A, Haidar L, Rifai N, Ahmed I and Mohamed Y. (2017). PROSPERO International prospective register of systematic reviews Long-term efficacy of antibiotic prophylaxis for preventing recurrent uncomplicated urinary tract infections: a systematic review and meta-analysis.
5. Salahia S, Safi O, Hakmi A A, Mahmoud H, Salahia S, Safi O, Efficacy, A et al (2017). PROSPERO International prospective register of systematic reviews Efficacy and safety of the angiotensin II receptor blocker losartan for hypertrophic cardiomyopathy: Systematic Review and Meta-Analysis.