Trimetazidine on Heart Rate Variability in Patients with Chronic Heart Failure:a meta-analysis

LIU Wan-li; HUANG He; WANG Lei; MEI Yang; LI Jun

doi:10.3969/j.issn.1002-3429.2014.12.035

Abstract：Objective To evaluate the efficacy of the improvement with trimetazidine on heart rate variability ( HRV) in patients with chronic heart failure ( CHF) . Methods The related Randomized Controlled Trial literature of TMZ influence on HRV in patients with CHF were searched by computer from Cochrane Central Register of Controlled Trials databases, PubMed, EMbase, WanFangDATA, Chinese academic journal full-text detabase ( CNKI) , Chinese Biomedical Literature Da-tabase (CBM), VIP database (VIP) and by hand during January 2005 and December 2013. All the data were processed by Meta-analysis using RevMan 5. 0. Results A total of 10 literatures, 991 patients ,including experimental group (convention-al therapy combined trimetazidine):500 cases and control group ( conventional treatment):491 cases, Literatures were medi-um quality. Meta-analysis showed that compared with the control group, left ventricular ejection fraction ( LVEF) in the ex-perimental group was obviously increased after therapy, and differences were statistically significant (P<0. 00001); In the indicators of HRV, standard deviation of all normal-to-normal intervals ( SDNN) , standard deviation of mean of all normalto-normal intervals in all consecutive 5-min segments of the entire recording ( SDANN) , root mean square of differences between adjacent normal-to-normal intervals ( rMSSD ) , the percentage of R-R intervals with more than 50 milliseconds variation (PNN50) were obviously increased or raised and all differences were statistically significant (P<0. 00001). There was little publication bias possibility in Meta-analysis a result from each symmetrical funnel schemas of above-mentioned indicators. Conclusion Existing evidence suggests that Trimetazidine combined therapy to patients with CHF has a curative effect, which can significantly improve LVEF, HRV, and can further improve the prognosis of patients with CHF.