Network Meta-analysis Of The β-blockers In The Treatment Of Dilated Cardiomyopathy With Heart Failure

Objective: A systematic review of the effects of different β-blockers on cardiac function and clinical effectiveness in patients with dilated cardiomyopathy and heart failure.Methods: Search commonly used Chinese and English databases to collect randomized controlled trials of β-blockers in the treatment of dilated cardiomyopathy with heart failure,carry out data extraction and quality evaluation,and use Stata 13.0software for data merging and analysis.To assess comprehensively the differences in heart rate,blood pressure,heart function,and clinical response to different beta blockers in patients with DCM heart failure.Results: This study finally included 50 articles,including 3038 patients with DCM with heart failure.The results of the study showed that compared with the group without beta blocker,the level of the heart rate,systolic blood pressure,diastolic blood pressure,LVEDD,LVESD,LVEF was significantly improved,and the clinical effective rate was significantly improved in the beta blocker group.The differences are statistically significant.Network meta-analysis results: A direct comparison of the Meta analysis showed that carvedilol can improve LVEDD,LVESD,LVEF and clinical effectiveness better than metoprolol and no beta-blockers,metoprolol and bisoprolol can significantly improve LVEF of DCM patients.Results of network meta-analysis showed that carvedilol and metoprolol were better than non-beta blockers in improving LVEDD,and carvedilol was better than metoprolol in improving LVEDD.In improving LVESD,carvedilol and bisoprolol were more effective than non-beta blockers,and both carvedilol and bisoprolol were better than metoprolol.In the aspect of improving LVEF,carvedilol,metoprolol and bisoprolol were more effective than those without beta blockers,both carvedilol and bisoprolol were better than metoprolol.In terms of clinical efficacy,carvedilol and bisoprolol were better than those without beta-blockers,and carvedilol and bisoprolol were better than those in metoprolol.Conclusions: Beta blocker therapy can significantly alleviate the clinical symptoms of DCM patients with heart failure,improve heart function,control heart rate and blood pressure,and improve the clinical efficiency.Among them,carvedilol is better in improving LVEDD and LVESD,and bisoprolol is better in improving LVEF and clinical efficiency.