Therapies to limit myocardial injury in animal models of myocarditis: a systematic review and meta-analysis.
Calcification
Drug treatment
Fibrosis
Meta-analysis
Myocarditis
Necrosis
Remodelling
Systematic review
Journal
Basic research in cardiology
ISSN: 1435-1803
Titre abrégé: Basic Res Cardiol
Pays: Germany
ID NLM: 0360342
Informations de publication
Date de publication:
31 10 2019
31 10 2019
Historique:
received:
16
07
2019
accepted:
07
10
2019
entrez:
2
11
2019
pubmed:
2
11
2019
medline:
10
4
2020
Statut:
epublish
Résumé
Current myocarditis guidelines do not advocate treatment to prevent myocardial injury and scar deposition in patients with myocarditis and normal left ventricular ejection fraction. We aimed to ascertain the utility of beta blockers, calcium channel blockers and antagonists of the renin-angiotensin system in ameliorating myocardial injury, scar formation and calcification in animal in vivo models of myocarditis. The project was prospectively registered with the PROSPERO database of systematic reviews (CRD42018089336). Primary outcomes (necrosis, fibrosis and calcification) were meta-analysed with random-effects modelling. 52 studies were systematically reviewed. Meta-analysis was performed compared with untreated controls. In each study, we identified all independent comparisons of treatment versus control groups. The pooled weighted mean difference (WMD) indicated treatment reduced necrosis by 16.9% (71 controlled analyses, 95% CI 13.2-20.7%; P < 0.001), however there was less evidence of an effect after accounting for publication bias. Treatment led to a 12.8% reduction in fibrosis (73 controlled analyses, 95% CI 7.6-18.0%; P < 0.001). After accounting for publication bias this was attenuated to 7.8% but remained significant. Treatment reduced calcification by 4.1% (28 controlled analyses, 95% CI 0.2-8.0%; P < 0.0395). We observed significant heterogeneity in effect size in all primary endpoints, which was predominantly driven by differences between drug categories. Beta blockers and angiotensin-converting enzyme (ACE) inhibitors were the only agents that were effective for both necrosis and fibrosis, while only ACE inhibitors had a significant effect on calcification. This study provides evidence for a role for ACE inhibitors and beta blockers to prevent myocardial injury and scar deposition in in vivo models of myocarditis. There is a need for further well-designed studies to assess the translational application of these treatments.
Identifiants
pubmed: 31673885
doi: 10.1007/s00395-019-0754-x
pii: 10.1007/s00395-019-0754-x
pmc: PMC6823299
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Calcium Channel Blockers
0
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
48Références
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
Cardiovasc Drugs Ther. 2007 Jun;21(3):155-60
pubmed: 17484035
Circulation. 2002 Dec 3;106(23):2967-72
pubmed: 12460880
PLoS One. 2012;7(6):e39394
pubmed: 22761780
Eur J Pharmacol. 2010 Aug 25;640(1-3):112-6
pubmed: 20457150
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
Circulation. 1996 Mar 1;93(5):841-2
pubmed: 8598070
Circulation. 2017 May 30;135(22):2106-2115
pubmed: 28351901
Am J Physiol Heart Circ Physiol. 2015 Jun 15;308(12):H1564-74
pubmed: 25862829
J Am Coll Cardiol. 2017 Oct 17;70(16):1964-1976
pubmed: 29025553
J Cardiovasc Pharmacol. 2003 Jan;41 Suppl 1:S105-10
pubmed: 12688405
Gene. 2014 Sep 1;547(2):195-201
pubmed: 24905653
Clin Sci (Lond). 2006 Mar;110(3):379-86
pubmed: 16336207
Circ J. 2003 Jun;67(6):545-50
pubmed: 12808275
Stroke. 2004 May;35(5):1203-8
pubmed: 15060322
Life Sci. 2009 Jul 31;85(5-6):235-40
pubmed: 19520090
Life Sci. 2013 Jul 10;92(24-26):1186-94
pubmed: 23702425
Int J Biol Sci. 2011;7(8):1077-92
pubmed: 21927577
Curr Cardiol Rev. 2019;15(1):12-23
pubmed: 30251607
Am Heart J. 1990 Dec;120(6 Pt 1):1377-81
pubmed: 2174203
Histol Histopathol. 2017 Apr;32(4):405-412
pubmed: 27615269
Am J Orthod Dentofacial Orthop. 2006 Aug;130(2):214-7
pubmed: 16905066
Biometrics. 2000 Jun;56(2):455-63
pubmed: 10877304
Eur Heart J. 2015 Nov 7;36(42):2921-2964
pubmed: 26320112
J Am Coll Cardiol. 1988 Aug;12(2):412-4
pubmed: 2839568
Circulation. 1991 Jan;83(1):52-60
pubmed: 1984898
J Med Virol. 2010 Dec;82(12):2043-52
pubmed: 20981792
Pharmacology. 2005 Feb;73(2):81-8
pubmed: 15467302
Scand J Immunol. 2010 Jan;71(1):38-44
pubmed: 20017808
Pharmacology. 2004 Sep;72(1):26-32
pubmed: 15292652
PLoS Biol. 2010 Mar 30;8(3):e1000344
pubmed: 20361022
J Cardiovasc Pharmacol. 2008 Jan;51(1):92-8
pubmed: 18209574
J Am Coll Cardiol. 2012 Feb 28;59(9):779-92
pubmed: 22361396
PLoS One. 2015 Nov 18;10(11):e0142021
pubmed: 26580958
J Cardiovasc Pharmacol. 1995 Jul;26(1):61-5
pubmed: 7564367
J Am Dent Assoc. 2006 Sep;137(9):1252-7
pubmed: 16946429
PLoS One. 2014 Jun 06;9(6):e98856
pubmed: 24906117
Am J Physiol Heart Circ Physiol. 2005 Oct;289(4):H1577-83
pubmed: 15923319
Circulation. 2009 May 12;119(18):2471-9
pubmed: 19398668
J Clin Invest. 1993 Jun;91(6):2727-33
pubmed: 8390488
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
Postgrad Med J. 2001 Jan;77(903):4-10
pubmed: 11123385
Herz. 2000 May;25(3):299-306
pubmed: 10904856
Am J Physiol Heart Circ Physiol. 2005 Sep;289(3):H1147-52
pubmed: 15879491
Cardiovasc Drugs Ther. 1999 May;13(3):249-58
pubmed: 10439888
J Pediatr Surg. 1994 Apr;29(4):492-4
pubmed: 8014800
Circulation. 2000 Nov 28;102(22):2700-6
pubmed: 11094035
Circulation. 1999 Mar 2;99(8):1091-100
pubmed: 10051305
Am J Physiol Heart Circ Physiol. 2004 Jan;286(1):H83-90
pubmed: 14684360
PLoS Med. 2010 Mar 30;7(3):e1000245
pubmed: 20361020
Life Sci. 2000 Jun 23;67(5):587-97
pubmed: 10993124
Circulation. 1990 Mar;81(3):1039-46
pubmed: 2155071
ILAR J. 2014;55(3):418-26
pubmed: 25541544
Am J Chin Med. 2006;34(3):493-502
pubmed: 16710898
Mol Cell Biochem. 2003 Jun;248(1-2):185-92
pubmed: 12870672
J Am Coll Cardiol. 2003 Jan 15;41(2):340-5
pubmed: 12535832
Am J Physiol Heart Circ Physiol. 2008 Jun;294(6):H2596-603
pubmed: 18408131
Circulation. 2003 May 27;107(20):2559-65
pubmed: 12732605
BMC Med Res Methodol. 2014 Mar 26;14:43
pubmed: 24667063
J Cardiovasc Pharmacol Ther. 2018 Jan;23(1):89-97
pubmed: 28854816
J Cardiol. 2016 Sep;68(3):253-60
pubmed: 26475067
N Engl J Med. 1995 Aug 3;333(5):269-75
pubmed: 7596370
Medicine (Baltimore). 1999 Jul;78(4):270-83
pubmed: 10424207
J Mol Cell Cardiol. 2011 Oct;51(4):449-50
pubmed: 21549125
J Neurosci Methods. 2014 Jan 15;221:92-102
pubmed: 24099992
Eur Heart J. 2012 Nov;33(22):2782-95
pubmed: 22942339
Eur Heart J. 2007 Jun;28(11):1326-33
pubmed: 17493945
Curr Med Chem Cardiovasc Hematol Agents. 2004 Oct;2(4):287-94
pubmed: 15320779
Circulation. 1997 Jan 7;95(1):245-51
pubmed: 8994443
Evid Based Dent. 2007;8(3):66-70
pubmed: 17891119
N Engl J Med. 1996 Oct 10;335(15):1107-14
pubmed: 8813041
Eur J Pharmacol. 2008 Sep 11;592(1-3):123-7
pubmed: 18627770
Eur Heart J. 2013 Sep;34(33):2636-48, 2648a-2648d
pubmed: 23824828
JACC Cardiovasc Imaging. 2019 Aug;12(8 Pt 2):1645-1655
pubmed: 30219397
JAMA. 2013 Mar 6;309(9):896-908
pubmed: 23462786
Pharmacology. 2006;77(1):1-10
pubmed: 16508340
Cardiovasc Res. 2017 Mar 1;113(3):288-297
pubmed: 28028069
J Am Coll Cardiol. 2017 Oct 17;70(16):1977-1987
pubmed: 29025554
Circulation. 2006 Aug 29;114(9):936-44
pubmed: 16908771
FASEB J. 2006 Jul;20(9):1546-8
pubmed: 16720735
Mol Cell Biochem. 2004 Apr;259(1-2):217-22
pubmed: 15124927