PMID- 37986143
OWN - NLM
STAT- MEDLINE
DCOM- 20231122
LR  - 20231124
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Nov 20
TI  - The efficacy of the treat-repair-treat strategy for severe pulmonary arterial 
      hypertension associated with congenital heart disease: a meta-analysis.
PG  - 569
LID - 10.1186/s12872-023-03606-z [doi]
LID - 569
AB  - BACKGROUND: This meta-analysis was conducted to evaluate the efficacy of the 
      treat-repair-treat (TRT) strategy in the treatment of severe pulmonary arterial 
      hypertension with congenital heart disease (PAH-CHD). METHODS: PubMed, EMBASE, 
      Cochrane and Web of Science online databases were searched by two independent 
      investigators for studies that used the TRT strategy for PAH-CHD, and the 
      retrieved studies were reviewed by a third investigator. The main outcomes were 
      pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), 6-minute 
      walk distance (6MWD), and transcutaneous oxygen saturation (SpO(2)). The changes 
      were compared between follow-up and baseline. Stata version 14.0 was used for 
      data analysis. A random-effects model was selected for meta-analysis. Subgroup 
      analysis and meta-regression were used to find the source of heterogeneity. 
      RESULTS: A total of 335 patients from 9 single-arm studies were included. 
      Meta-analysis showed significant reductions in PAP and PVR and improvements in 
      6MWD and SpO(2) (PAP: SMD -2.73 95% CI -2.97, - 2.50 p = < 0.001; PVR: SMD -1.27 
      95% CI -1.53, - 1.02 p = < 0.001; 6MWD: SMD 1.88 95% CI 1.49, 2.27 p = < 0.001; 
      SpO(2): SMD 3.72 95% CI 3.13, 4.32 p = < 0.001). Subgroup analysis showed that 
      younger patients had better efficacy, and the change in SpO(2) was an indication 
      for patient selection. The combined mortality rate was 5% at follow-up. 
      CONCLUSIONS: In this meta-analysis, we demonstrated that the TRT strategy may 
      have positive effects on haemodynamics and cardiac function in patients with 
      severe PAH-CHD at short-term follow-up. Our analysis suggests that changes in age 
      and SpO(2) may be related to patient prognosis. TRIAL REGISTRATION: The protocol 
      was registered on the PROSPERO website with the registration number 
      CRD42022366552. The relevant registration information can be obtained from the 
      website https://www.crd.york.ac.uk/prospero/#searchadvanced .
CI  - (c) 2023. The Author(s).
FAU - Wang, Zhiyuan
AU  - Wang Z
AD  - Department of Cardiac Surgery, The First Hospital of Hebei Medical University, 
      No. 89, Donggang Road, Yuhua District, Shijiazhuang City, Hebei Province, China.
FAU - Li, Xiaobing
AU  - Li X
AD  - Department of Cardiac Surgery, The First Hospital of Hebei Medical University, 
      No. 89, Donggang Road, Yuhua District, Shijiazhuang City, Hebei Province, China.
FAU - Li, Mengxuan
AU  - Li M
AD  - Department of Cardiac Surgery, The First Hospital of Hebei Medical University, 
      No. 89, Donggang Road, Yuhua District, Shijiazhuang City, Hebei Province, China.
FAU - Peng, Jun
AU  - Peng J
AD  - Department of Cardiac Surgery, The First Hospital of Hebei Medical University, 
      No. 89, Donggang Road, Yuhua District, Shijiazhuang City, Hebei Province, China.
FAU - Zhang, Huijun
AU  - Zhang H
AD  - Department of Cardiac Surgery, The First Hospital of Hebei Medical University, 
      No. 89, Donggang Road, Yuhua District, Shijiazhuang City, Hebei Province, China. 
      zhanghuijunwzy@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20231120
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Humans
MH  - *Pulmonary Arterial Hypertension/diagnosis/drug therapy/complications
MH  - *Hypertension, Pulmonary/complications
MH  - Familial Primary Pulmonary Hypertension
MH  - *Heart Defects, Congenital/complications/diagnosis
MH  - Arteries
PMC - PMC10662905
OTO - NOTNLM
OT  - Congenital heart disease
OT  - Pulmonary arterial hypertension
OT  - Targeted drugs
OT  - Treat-repair-treat
COIS- The authors declare no competing interests.
EDAT- 2023/11/21 06:42
MHDA- 2023/11/22 06:43
PMCR- 2023/11/20
CRDT- 2023/11/21 04:06
PHST- 2022/11/11 00:00 [received]
PHST- 2023/11/09 00:00 [accepted]
PHST- 2023/11/22 06:43 [medline]
PHST- 2023/11/21 06:42 [pubmed]
PHST- 2023/11/21 04:06 [entrez]
PHST- 2023/11/20 00:00 [pmc-release]
AID - 10.1186/s12872-023-03606-z [pii]
AID - 3606 [pii]
AID - 10.1186/s12872-023-03606-z [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2023 Nov 20;23(1):569. doi: 10.1186/s12872-023-03606-z.