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Cardioprotective effect of histamine H2 antagonists in congestive heart failure: A systematic review and

Juan Zhang1, Wen-Ke Cai, Zheng Zhang

  • 1Research Center of Clinical Pharmacology, Yunnan Provincial Hospital of Traditional Chinese Medicine Department of Pharmacy Department of Cardio-Thoracic Surgery, Kunming General Hospital of PLA, Kunming Medical Engineering Section, the 306th Hospital of PLA, Beijing Department of Orthopaedics, Guangzhou General Hospital of PLA, Guangzhou, China.

Medicine
|April 12, 2018
PubMed

Insights

Histamine H2 receptor antagonists (H2RAs) reduce heart rate and blood pressure in congestive heart failure patients. These effects may decrease myocardial oxygen demand, potentially improving heart failure symptoms.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Histamine H2 receptor antagonists (H2RAs) are hypothesized to benefit congestive heart failure (CHF).
  • The cardioprotective effects of H2RAs remain debated.
  • Clarifying H2RA impact on myocardial function in CHF is crucial.

Purpose of the Study:

  • To meta-analyze the effects of H2RAs on myocardial function in CHF patients.
  • To evaluate the impact of H2RAs on heart rate, blood pressure, and other cardiac parameters.

Main Methods:

  • Systematic retrieval of randomized controlled trials from PubMed, Embase, and Cochrane Library.
  • Meta-analysis of 10 studies (472 participants) comparing H2RAs with placebo or other interventions.
  • Calculation of pooled mean differences and confidence intervals using RevMan 5.3 software.

Main Results:

  • H2RAs demonstrated significant negative inotropic and chronotropic effects, reducing heart rate (MD: -3.90; 95%CI: -7.07 to -0.73).
  • H2RAs significantly decreased blood pressure in CHF patients, unlike in healthy volunteers.
  • An increased pre-ejection period and pre-ejection period to left ventricular ejection time ratio were observed with H2RAs.

Conclusions:

  • H2RAs exert negative inotropic and chronotropic effects, lowering heart rate and blood pressure.
  • These effects may reduce myocardial oxygen demand, similar to beta-blockers.
  • H2RAs offer a potential strategy for improving CHF symptoms and cardiac function.
Abstract

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