The efficacy of baroreflex activation therapy for heart failure: A meta-analysis of randomized controlled trials

Medicine (Baltimore). 2020 Nov 6;99(45):e22951. doi: 10.1097/MD.0000000000022951.

Abstract

Introduction: The efficacy of baroreflex activation therapy for heart failure is elusive. This meta-analysis aims to evaluate the impact of baroreflex activation therapy on treatment efficacy of heart failure.

Methods: Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases have been searched, and we include randomized controlled trials (RCTs) regarding the efficacy of baroreflex activation therapy for patients with heart failure.

Results: This meta-analysis includes 4 RCTs. Baroreflex activation therapy shows significantly positive impact on the quality of life score (standard mean difference SMD = -4.61; 95% confidence interval CI = -6.24 to -2.98; P < .00001), 6-minute hall walk (6MHW) distance (SMD = 2.83; 95% CI = 1.44- 4.22; P < .0001), New York Heart Association (NYHA) Class (SMD = -3.23; 95% CI = -4.76 to -1.69; P < .0001), N-terminal pro-brain natriuretic peptide (NT-proBNP) (SMD = -1.24; 95% CI = -1.58 to -0.89; P < .00001) and the duration of hospitalization (SMD = -1.65; 95% CI = -2.90 to -0.39; P = .01) compared with control group for heart failure, but has no obvious effect on left ventricular ejection fraction (LVEF) (SMD = 1.43; 95% CI = -0.15-3.01; P = .08), or the number of hospitalization per year (SMD = -1.17; 95% CI = -2.56-0.22; P = .10).

Conclusions: Baroreflex activation therapy can improve the treatment efficacy for heart failure.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Baroreflex*
  • Electric Stimulation Therapy*
  • Heart Failure / therapy*
  • Humans
  • Implantable Neurostimulators
  • Length of Stay
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Walk Test

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain