Risultati per: Infezione da Helicobacter pylori: review

Dinis-Ribeiro M, Shah S, El-Serag H, et al. The road to a world-unified approach to the management of patients with gastric intestinal metaplasia: a review of current guidelines. Gut 2024;73:1607-17.
The affiliation for Ernst J Kuipers has been corrected in the online version only to:
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

Circulation, Volume 150, Issue Suppl_1, Page A4148096-A4148096, November 12, 2024. Introduction:There is a lack of good risk prediction models in patients with stable coronary artery disease (SCAD). We conducted a meta-analysis of validation studies to compare and determine the discrimination abilities of Euroscore (ES) and Syntax score (SS) for prognostic outcomes in patients with SCAD.Methods:A comprehensive literature search was conducted across MEDLINE, Cochrane and Embase from inception till May 2024. All studies that reported C-statistic/AUC for predicting all cause mortality, cardiac death or Major adverse cardiovascular events (MACE) for patients with stable coronary artery disease (SCAD) were included in the analysis. Studies lacking confidence intervals (CI) for C-statistic or those which reported C-statistics in patients with acute coronary syndromes or mixed SCAD and ACS patients were excluded. A generic inverse variance method was used to pool C-statistics and their corresponding standard errors (SEs). The SEs were calculated from CI wherever needed. A pooled C statistic of >0.8 was considered to be a good discrimination ability.Results:A total of 5 studies with a patient population of 5903 were included in the meta-analysis. For ES, the pooled C-statistic for all cause mortality (n=2666) was 0.69[0.51-0.87] while for cardiac death (n=2666) it was 0.77[0.60-0.71]. The discrimination ability of ES for MACE as reported by one study (n=305) was 0.54[0.49-0.60]. For SS, the summary AUC for all cause mortality (n=2936) was 0.77[0.69-0.85] while for cardiac death (n=305) it was 0.52[0.46-0.57]. The pooled AUC of SS for occurrence of MACE(n=2666) was 0.56[0.45-0.66].Conclusion:None of the two scores have a a good discrimination ability for risk stratification in SCAD patients. The predictive accuracy of SS is comparatively better than ES for all cause mortality. However, ES performs better for predicting cardiac death. Better risk prediction models with large scale external validations are needed.

Circulation, Volume 150, Issue Suppl_1, Page A4144574-A4144574, November 12, 2024. Background:According to the American Cancer Society, there are currently over 18 million adult cancer survivors in the US, and by 2030, that figure is estimated to rise to over 22 million. While this is positive, more and more survivors are now at risk for cardiovascular disease (CVD).Hypothesis:This meta-analysis aims to evaluate the association between cancer survivors and cardiovascular event.Methods:A systematic search was conducted in electronic databases from inception until March 2024 using appropriate Mesh terms for ‘Cancer’, and ‘cardiovascular risk’. Pooled risk ratios (RR) with their corresponding 95% confidence intervals (CI) were calculated using random effects models. A p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4148074-A4148074, November 12, 2024. Introduction/Background:Transradial cardiac catheterization (TRC) is recommended for patients with acute coronary syndrome over femoral artery catheterization. Randomized controlled trials show TRC has significantly lower rates of bleeding, vascular complications, and mortality in high-risk acute coronary syndrome patients. However, vascular complications like radial artery spasm, occlusion, arteriovenous fistula, perforation, and pseudoaneurysm (PSA) can still occur. Despite TRC’s widespread adoption, recent data summarizing radial artery pseudoaneurysm post-TRC is lacking.Research Question/HypothesisThis review aims to identify at-risk patients, present a case of catheterization-related radial artery pseudoaneurysm, and provide diagnostic and management insights. We hypothesize that older patients with hypertension are at higher risk and that early detection and management are associated with low complication rates.Methods/Approach:Systematic searches were conducted in PubMed, Web of Science, EMBASE, and CINAHL databases. Two researchers independently selected articles, extracted data, and evaluated study quality on RA PSA post-TRC (2003–2023). A third reviewer resolved conflicts. The Joanna Briggs Institute (JBI) tool was used to evaluate bias risk. Additionally, a case report is presented.Results:From 3,262 records, 43 studies were selected, involving 67 patients (58.8% female, median age 73.5 years). Hypertension (39.5%) and atrial fibrillation (27.9%) were the most common comorbidities. Percutaneous interventions like stenting and angioplasty caused 58.1% of cases; diagnostic catheterizations accounted for 37.2%. Ultrasonography diagnosed 83.7% of cases. Symptoms appeared a few hours to four months post-TRC, with pulsatile mass (21.4%) and swelling (14.3%) being the most common, and pain and ecchymosis at 2.4% each. More than half of the patients (51.2%) required surgical intervention, but 66.7% recovered without deficits. Severe complications were rare, affecting fewer than 5%.Conclusions:A literature review of 43 articles with 67 patients suggests older female patients with hypertension may be more prone to radial artery pseudoaneurysm post-TRC. It typically presents as a pulsatile, painful swelling detectable by ultrasound. This complication precludes the use of the radial artery as a conduit for coronary artery bypass grafting. The review highlights the importance of vigilant post-catheterization monitoring to enable early detection and treatment.

Circulation, Volume 150, Issue Suppl_1, Page A4140134-A4140134, November 12, 2024. Background:Cardiovascular diseases are the second leading cause of death among cancer patients, after cancer-related mortality. It has not been well established if a patient’s malignancy status increases their risk of cardiovascular events following a myocardial infarction (MI).Hypothesis:This study aims to assess the impact of cancer on cardiovascular outcomes following an acute myocardial infarction.Methods:We systematically searched electronic databases such as Pubmed, Embase and Cochrane Library from inception until March 2024 using the appropriate Mesh terms, “ cancer,” “myocardial infarction,” and “cardiovascular mortality”, “in-hospital mortality”. Pooled relative risk and their corresponding confidence interval were calculated using the random effect model. A p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4141475-A4141475, November 12, 2024. Background:Acute Kidney Injury (AKI) is a multifactorial complication following repair of Stanford Type A aortic dissection (TAAD) with an alarmingly high incidence, varying from 20 to 77%. Postoperative AKI following life-threatening disease tends to be much more complex. However, the exact role of postprocedural AKI in the prognosis of patients undergoing TAAD repair has not been elucidated.Aims:This meta-analysis aimed to evaluate the prognostic significance of postprocedural AKI in patients undergoing TAAD repair.Methods:A literature search was conducted using PubMed, EMBASE, and SCOPUS databases. The primary endpoint was 30-day mortality with several secondary endpoints. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled using Review Manager software. Statistical significance was set at p

Circulation, Volume 150, Issue Suppl_1, Page A4148089-A4148089, November 12, 2024. Background:Ventricular arrhythmias are major causes of morbidity and mortality in patients with cardiovascular disease. Implantable cardioverter-defibrillators (ICDs) are commonly used to prevent sudden cardiac death in these patients. However, patients with ICDs frequently experience recurrent arrhythmias and inappropriate shocks, which can impact their quality of life. Beta-blockers, specifically carvedilol and metoprolol, are commonly prescribed to manage these arrhythmias. This meta-analysis aims to compare the impact of both medications in this patient population.Methods:A comprehensive literature search was conducted to identify relevant studies comparing carvedilol to metoprolol in patients with ventricular arrhythmias or ICDs. Study outcomes included all-cause mortality, recurrent ventricular arrhythmia, and inappropriate ICD shocks. Effect estimates are presented as hazard ratios (HR) with 95% confidence intervals (CI).Results:1,453 studies were identified through database search. After full-text screening, a total of 5 studies involving 9,292 patients were included. We found no significant difference in the incidence of recurrent ventricular arrhythmias between carvedilol and metoprolol (HR = 0.99, 95% CI [0.75, 1.32], P = 0.97). Additionally, Carvedilol showed a trend toward reduction of all-cause mortality (HR = 0.83, 95% CI [0.68, 1.03], P = 0.09). On the other hand, Carvedilol was associated with a statistically significant reduction of inappropriate ICD shocks (HR = 0.61, 95% CI [0.48, 0.78], P < 0.001).Conclusion:Carvedilol may offer additional benefits over metoprolol in managing patients with ventricular arrhythmias or ICDs, particularly in minimizing the incidence of inappropriate ICD shocks. However, no significant difference was found in terms of all-cause mortality and recurrent ventricular arrhythmia incidence. Further research is needed to confirm these findings and guide clinical decision-making.

Circulation, Volume 150, Issue Suppl_1, Page A4136971-A4136971, November 12, 2024. Background:Non-sustained ventricular tachycardia (NSVT) has been shown to be independently associated with sudden cardiac death (SCD) among patients with hypertrophic cardiomyopathy (HCM). There is limited evidence regarding the efficacy of late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging to predict the incidence of NSVT.Aims:To address this gap in knowledge, our meta-analysis aims to comprehensively evaluate the prognostic value of LGE on cardiac magnetic resonance in predicting the incidence of NSVT in HCM.Methods:PubMed, Embase and Cochrane CENTRAL databses were queried from inception until May 2024 for all studies assessing the prognostic value of LGE on CMR in patients with HCM and reported the incidence of NSVT. Data were combined using a random-effects model meta-analysis to determine the pooled sensitivity, specificity and accuracy of LGE in predicting NSVT in patients with HCM. The association between the LGE extent on CMR and NSVT incidence was also assessed, and weighted mean differences (WMDs) were reported with 95% condidence intervals (CIs). Heterogeneity across the studies was evaluated using the HigginsI2statistic.Results:A total of twenty studies were included in our analysis. The pooled senstivity, specificity, and accuracy of LGE in predicting the incidence of NSVT among HCM patients was 91.33%, 37.45%, and 52.86%, respectively. Moreover, we saw a significantly greater extent of LGE (5.95%, CI: 3.08-8.81, P

Circulation, Volume 150, Issue Suppl_1, Page A4120583-A4120583, November 12, 2024. Background:First generation drug eluting stents (DES) with thick polymers may contribute to local vascular inflammation and late stent thrombosis. Thinner-strut DES (ultrathin), particularly those with biodegradable polymers, aim to reduce this risk by minimizing flow disturbance and vascular injury. However, the long-term safety and efficacy of ultrathin biodegradable polymer sirolimus eluting stents (BP-SES) compared to durable polymer everolimus eluting stents (DP-EES) are still uncertain. Thus, we performed a meta analysis to compare outcomes of these two stents.Methods:Inclusion criteria comprised randomized controlled trials comparing ultrathin BP SES and thin DP EES in patients undergoing percutaneous coronary interventions with long term follow-up of at least 3 years. We excluded cohort studies, case reports, editorials, conference abstracts, and animal studies. Primary outcomes were target lesion failure (TLF), cardiac death (CD), target-vessel myocardial infarction (TV-MI), and clinically indicated target lesion revascularization (CI-TLR). We systematically searched PubMed, Cochrane CENTRAL, and Scopus. Cochrane’s ROB 2.0 tool assessed trial quality, and RevMan software (5.4) performed the meta-analysis.Results:Our analysis included ten RCTs, totaling 16,216 patients, with 9,108 in the BP SES group and 7,108 in the DP EES group. TLF occurred in 905 patients (9.94%) in the BP-SES group and 821 patients (11.55%) in the DP-EES group, with no statistically significant differences between the groups (RR = 0.92, 95% CI = 0.85 to 1.01, p = 0.08). Additionally, there were no significant differences in cardiac death (RR = 1.00, 95% CI = 0.84 to 1.19, p = 1.00), TV-MI (RR = 0.91, 95% CI = 0.78 to 1.05, p = 0.19), and CI-TLR (RR = 0.88, 95% CI = 0.78 to 1.01, p = 0.06) between the two groups.Conclusion:The use of BP-SES did not result in higher rates of TLF, CD, TV-MI, or CI-TLR compared to DP-DES. These findings suggest that both BP-SES and DP-DES are viable options for PCI procedures, with comparable long-term safety profiles. However, some trials used strut thicknesses exceeding 70µm in cases requiring wider diameters, similar to the strut thickness in the DP-EES group. This makes it challenging to assess whether, in addition to biodegradable polymers, lower strut thickness contributes to reducing target lesion-related events. Further research may be needed to explore other relevant outcomes and to confirm these findings in diverse patient populations.

Circulation, Volume 150, Issue Suppl_1, Page A4145880-A4145880, November 12, 2024. Background:Patients with hematological malignancies may face increased cardiovascular risks, including acute myocardial infarction (AMI). This systematic review and meta-analysis aims to evaluate the incidence and outcomes of AMI in patients with hematological malignancies compared with the general population.Methods:A comprehensive literature search was conducted using the PubMed, Embase, and Google Scholar databases. Random effect models were utilized to calculate Mantel-Haenszel odds ratios (ORs) with 95% confidence intervals (CIs). The inverse variance method with DerSimonian–Laird (DL) of Tau2 was used to calculate standardized mean differences (SMDs) with CIs. Statistical significance was set at p < 0.05. The primary endpoint was the incidence of AMI, while secondary outcomes included in-hospital mortality, length of hospital stay, likelihood of undergoing invasive procedures, total hospital costs, bleeding events, and stroke outcomes.Results:Twenty-six articles, including approximately 6.33 million patients with hematological malignancies, were included in the meta-analysis. Hematological malignancies were not associated with an increased incidence of AMI compared with the general population (OR = 0.91; 95% CI 0.80 to 1.03; p

Circulation, Volume 150, Issue Suppl_1, Page A4136033-A4136033, November 12, 2024. Background:Folic acid, a B vitamin, is essential for DNA synthesis and repair, and its role in reducing homocysteine levels has been linked to cardiovascular health. Elevated homocysteine is a risk factor for cardiovascular diseases, including acute myocardial infarction (MI) and coronary artery disease (CAD). Despite evidence suggesting that folic acid supplementation may lower homocysteine levels, its clinical benefits in reducing cardiovascular events remain unclear.Methods:A comprehensive literature search was conducted in PubMed/Medline, Google Scholar, and Cochrane Library databases for studies published from 2000 to 2024 using MeSH terms related to “folic acid,” “B vitamin,” “acute myocardial infarction,” “cardiac arrest,” “heart attack,” and “coronary heart disease.” Only randomized controlled trials (RCTs) and observational studies in English involving adult patients with acute MI or CAD were included. Exclusion criteria were applied to poor-quality studies, irrelevant outcomes, overlapping populations, and non-English texts. Data on study characteristics and patient demographics were extracted, and study quality was assessed using the RoB2 tool. Outcomes were pooled using RevMan 5.3.4 software.Results:Fourteen studies on all-cause mortality showed a risk ratio (RR) of 0.99 [95% CI: 0.94-1.04], indicating no significant difference between folic acid and control groups. Eight studies on cardiovascular mortality yielded a RR of 0.90 [95% CI: 0.82-0.99], suggesting a significant reduction in cardiovascular deaths with folic acid supplementation. Analyses of sudden death, coronary artery bypass graft (CABG) events, revascularization procedures, stroke, and recurrent MI found no significant associations with folic acid supplementation.Conclusions:High-dose folic acid supplementation appears to reduce cardiovascular mortality in post-MI patients but shows no significant impact on other clinical outcomes. This meta-analysis’s limitations include potential publication bias, heterogeneity among included studies, and variability in folic acid dosages and treatment durations. Furthermore, the lack of comprehensive homocysteine level data constrained the analysis. Future large-scale RCTs are needed to fully ascertain the therapeutic potential of folic acid supplementation in secondary prevention of cardiovascular events.

Circulation, Volume 150, Issue Suppl_1, Page A4142086-A4142086, November 12, 2024. Background:Congenital heart diseases affect one in every 100 live births. Surgical intervention is necessary for almost half of these cases, with a significant proportion requiring surgery within the first year after birth. This meta-analysis aims to evaluate the efficacy and safety of inhaled nitric oxide (iNO), selective pulmonary vasodilator, particularly its impact on perioperative clinical outcomes such as low cardiac output syndrome (LCOS), duration of mechanical ventilation, blood and fresh frozen plasma (FFP) transfusion, ICU stay, and hospital stay.Methods:We conducted a comprehensive search of PubMed, Scopus, WOS, and Cochrane databases for relevant studies from inception to April 1, 2024. We included randomized controlled trials (RCTs) comparing iNO with placebo or standard care in pediatric patients undergoing cardiopulmonary bypass. Data extraction and quality assessment were performed according to PRISMA guidelines and Cochrane’s risk of bias tool. Mean differences (MD) and their 95% confidence intervals (CI) were calculated using OpenMeta [Analyst].Results:We included six RCTs in our meta-analysis. Our analysis showed that iNO significantly reduced the duration of mechanical ventilation (MD = -5.733, 95% CI [-10.494; -0.972]). However, no significant differences were observed between the iNO group and the control group for hospital stay, ICU stay, or incidence of LCOS. Safety outcomes showed no significant differences in blood or platelet transfusion rates, though iNO was associated with statistically significant lower FFP transfusion (MD = -5.199, 95% CI [-8.032; -2.366]).Conclusion:our review and meta-analysis highlights the potential benefits of iNO in reducing ventilation time and FFP transfusion in pediatric patients undergoing cardiac surger, while also emphasizing the need for further research to conclusively determine its impact on other clinical outcomes and safety parameters.

Circulation, Volume 150, Issue Suppl_1, Page A4148133-A4148133, November 12, 2024. Background:Left ventricular assist devices (LVADs) are crucial for the management of advanced heart failure patients acting, both as a bridge to heart transplant or destination therapy. Existing studies revealed mixed results on the impact of pre-implant left ventricular end-diastolic diameter (LVEDD) on post-LVAD mortality. Some studies found smaller LVEDD increases mortality, while others revealed no significant impact. Due to the limited evidence, this meta-analysis aims to determine the association between pre-LVEDD and post-LVAD implantation mortality through a systematic review and meta-analysis.Method:We systematically reviewed articles until May 2024 examining the association between pre-implant LVEDD and post-LVAD implantation mortality using PubMed, Google Scholar, Embase, and Scopus. A random effects model was used to calculate the pooled adjusted odds ratio (aOR). We used I2statistics to determine the heterogeneity of studies. Leave-one-out sensitivity analysis was done to evaluate each study’s effect on the overall estimate, with statistical significance set at p

Circulation, Volume 150, Issue Suppl_1, Page A4140276-A4140276, November 12, 2024. Background:The potential benefits and risks of combination sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) therapy versus (vs.) monotherapy, remain a subject of debate to reduce metabolic and cardiovascular outcomes in patients with diabetes mellitus. This study aims to systematically review and meta-analyze the available evidence from randomized controlled trials (RCTs).Methods:A comprehensive search identified relevant RCTs comparing combination therapy with SGLT-2i and GLP-1RA to monotherapy or placebo. The primary outcome was the incidence of major adverse cardiovascular events (MACE) (all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and hospitalization for heart failure (hHF)). Secondary outcomes included changes in metabolic parameters and adverse events. Random-effects meta-analysis estimated risk ratios, mean difference, and 95% confidence intervals (CI).Results:The meta-analysis included 11 RCTs with 42,851 participants, of which 2,870 on combination therapy, and the rest on SGLT-2i (37.1%), GLP-1RA (20.1%) monotherapies or placebo (42.8%). Combination therapy had a significantly lower risk of MACE vs. GLP-1RA monotherapy (RR=0.81, 95% CI 0.65;1.00) and placebo (RR=0.73, 95% CI 0.61;0.88). Combination therapy also had a lower risk of hHF vs. GLP-1RA, SGLT-2, and placebo monotherapies (RR=0.37, 95% CI 0.22;0.65), (RR=0.37, 95% CI 0.19;0.75), and (RR=0.43, 95% CI 0.24;0.75), respectively. Combination therapy was showed greater weight loss and HbA1c reduction vs. SGLT-2i monotherapy (MD=-2.03, 95% CI -2.85;-1.21 and MD=-0.74, 95% CI -1.21;-0.27), respectively, while no difference vs. GLP-1RA monotherapy. Incidence of nausea and diarrhea was higher with combination therapy vs. SGLT-2i monotherapy (MD=3.34, 95% CI 1.74;6.43 and MD=1.75, 95% CI 1.10;2.77), respectively.Conclusion:Combination SGLT-2i and GLP-1RA therapy may provide superior cardiovascular, weight, and HbA1c outcomes vs. monotherapy, despite higher gastrointestinal adverse events. These results impact the management of patients with metabolic and cardiovascular diseases, and highlighting the need for further research to optimize combination therapy.

Circulation, Volume 150, Issue Suppl_1, Page A4145951-A4145951, November 12, 2024. Background:Cardiac amyloidosis is an underdiagnosed cause of heart failure. The mean survival rate without treatment is low, signifying the importance of early diagnosis. The prognosis depends on the time of diagnosis and the severity of the disease before recognition and treatment. We performed a systematic review to evaluate patient characteristics and mortality in individuals with cardiac amyloidosis.Methods:PubMed, Scopus and Cochrane were systematically searched from the database inception to May 2024 to evaluate for mortality outcomes in patients with cardiac amyloidosis. The statistical analysis was performed using R-Studio software, and proportions with 95% confidence intervals (CI) were calculated using a random-effects model. The Kaplan Meier survival plots was also plotted for eligible studies.Results:Eighteen studies involving 7,268 patients were included. Patients with cardiac amyloidosis mostly presented with dyspnea and peripheral edema. Among the electrocardiographic abnormalities, atrial fibrillation was observed in 31.1% of patients, whereas atrioventricular block was observed in 6.2% of patients. Furthermore, 37.2% of patients experienced heart failure, 36.3% experienced reduced ejection fraction, and 3.2% of patients experienced cardiogenic shock. Majority of the patients were found to have an increase in left ventricular wall thickness (77.8%). The mortality associated with cardiac amyloidosis varied from 0% to 100%, with a summary estimate rate of 54% (95% CI: 31% to 77%). The median survival rate for 50% patients was around 2 weeks, which declined significantly over the next one week resulting into the cumulative survival of over only 21 days.Conclusion:Our results highlight the importance of considering cardiac amyloidosis in the differential diagnosis of all patients with heart failure or non-ischemic cardiomyopathy, particularly when there is an increase in ventricular wall thickness. Our review revealed a high mortality rate associated with cardiac amyloidosis. Early diagnosis and better therapeutic modalities have the potential to improve patient outcomes and reduce mortality rates.

Circulation, Volume 150, Issue Suppl_1, Page A4144404-A4144404, November 12, 2024. Introduction:Mavacamten, a cardiac myosin inhibitor, distinguishes from other pharmacological interventions by addressing not only symptomatic treatment but also targeting the underlying pathophysiological mechanisms in Hypertrophic Cardiomyopathy (HCM). Therefore, we aimed in our meta-analysis to evaluate the impact of mavacamten on echocardiographic parameters and cardiac biomarkers in HCM patients.Methods:We searched different databases such as PubMed, SCOPUS, WOS, and Cochrane from inception until February 20, 2023, for any randomized controlled trials (RCTs) that compare mavacamten to placebo in HCM patients and report the echocardiographic parameters. Our outcomes of interest were diastolic function parameters [lateral and septal early diastolic mitral annular velocity (lateral e’ and septal e’), lateral and septal ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity of the septum (E/e’ lateral and septal ratio)], left ventricular parameters [left ventricular ejection fraction (LVEF) and left ventricular outflow tract (LVOT) valsalva gradient ], as well as cardiac biomarkers [NT-proBNP and troponin]. We used the mean difference (MD) for continuous outcomes with the corresponding 95% confidence interval (CI).Results:Four RCTs with a total of 503 patients were included. Mavacamten led to a significant improvement in lateral e’ and septal e’, (MD=1.43, 95% CI [1.06, 1.79]), (MD=0.78, 95% CI [0.51, 1.05]) respectively compared to placebo. Furthermore, mavacamten was superior to placebo in reducing E/e’ lateral ratio, (MD=-3.05, 95% CI [-5.05, -1.05]) E/e’ septal ratio (MD=-3.38, 95% CI [-4.50, -2.25]), LVEF, and LVOT valsalva gradient, (MD=-3.52, 95% CI [-4.76, -2.27]), (MD=-51.02, 95% CI [-69.66, -32.38]), respectively. Regarding to cardiac biomarkers, mavacamten demonstrated substantial efficacy in reducing NT-proBNP (MD=-557.14, 95% CI [-685.59, -428.68]), and troponin (MD=-8.47, 95% CI [-12.73, -4.21]).Conclusion:Our meta-analysis reveals that mavacamten significantly enhanced echocardiographic outcomes for diastolic function and left ventricular parameters. Also, mavacamten led to a significant reduction in cardiac biomarkers.