Abstract 6148: Favorable Effects of Vasodilators on Left Ventricular Remodeling in Asymptomatic Chronic Severe Aortic Regurgitation with Normal Ejection Fraction: A Meta-Analysis
The role of vasodilator therapy in asymptomatic chronic severe aortic regurgitation (AR) with normal left ventricular (LV) function is uncertain. We assessed the effects of vasodilator therapy (hydralazine, calcium channel blockers and angiotensin-converting enzyme inhibitors) in asymptomatic chronic severe aortic regurgitation with normal LV function. We performed a systematic literature search for randomized clinical trials using long term vasodilator therapy in asymptomatic chronic severe AR with normal LV function. The magnitude of difference between the vasodilator and non-vasodilator groups was assessed by computing the mean difference (MD). Heterogeneity of the studies was analyzed by Cochran’s Q statistics. The MD for LV ejection fraction, LV end systolic volume index and LV end diastolic volume index were computed by random effect model. The MD for LV end systolic diameter and LV end diastolic diameter were computed by fixed effect model. A two-sided alpha error of less than 0.05 was considered to be statistically significant. Seven studies with 467 patients were included. Meta-analysis of the studies revealed a significant increase in LV ejection fraction (MD, 5.32; 95% CI, 0.37 to 10.26; p = 0.035), decrease in LV end systolic volume index, a significant decrease in LV end diastolic volume index and a significant decrease in LV end systolic diameter in the vasodilator group compared to the non-vasodilator group. The results are summarized in the figure⇓ below. In asymptomatic chronic severe AR with normal LV function, vasodilators have favorable effects on LV remodeling.