Shengmai (a traditional Chinese herbal medicine) for heart failure

Jin Chen; Gang Wu; Shuangqing Li; Tao Yu; Yao Xie; Liping Zhou; Lei Wang

doi:10.1002/14651858.CD005052.pub2

Shengmai (una hierba medicinal china tradicional) para la insuficiencia cardíaca

Contraer todo Desplegar todo

Referencias

Referencias de los estudios incluidos en esta revisión

Ir a:

estudios excluidos
estudios a la espera de valoración
otras referencias

Xing‐ming Cen, Jin‐Sheng Li, Jian Bin Mao. The effect of Shengmai injection on QT dispersion for congestive heart failure. Peoples Military Surgeon 1999;42(11):649‐50.

Google Scholar

Li‐li Cheng. The effect of Shengmai injection on serum enzyme for pulmonary heart disease. Chinese Journal of Integrated Traditional and Western Medicine 2001;21(10):790.

Google Scholar

Ya‐Dong Gao. The effect of Shengmai injection for acute heart failure of pulmonary heart disease. Journal of Jinggangshan Medical College 2001;8(1):62.

Google Scholar

Zhi‐Fa He. The effect of Shengmai complementary treatment for 40 patients with congestive heart failure. Tianjin Pharmacy 2001;13(4):44.

Google Scholar

You‐Zuo He, Xiu‐Hua Li, Chun‐Yong Li, Xu‐Fen Zhao, Wan‐Lin Li, Zheng‐Hui Liu. Effects of Shengmai injection on congestive heart failure patients with abnormal flow mediated dilation of brachial artery volume. Chinese Heart Journal 2004;16(2):137‐9.

Google Scholar

Ya‐Li Hu, Feng‐Xia Li, Zhi‐Zhang Yu, Zhi‐Shen Zhng, Guo‐Qiang Li, Hui‐Ru Su, Zhong‐Cheng Li. The effects of Shengmai injection and sodium nitroprusside in 36 patients with heart failure of ischemic heart disease. Integrated Traditional Chinese and Western Medicine in Practice of Critical Care Medicine 1998;5(3):139‐40.

Google Scholar

Jia‐Xuan Li, Tian‐Xia Huang. Clinical analysis of Shengmai injection for 64 patients with refractory heart failure of pulmonary heart disease. Practical Geriatrics 1998;12(4):181‐2.

Google Scholar

Hong‐feng Li, Cheng‐rong Zhao. The effect of Shengmai injection for refractory heart failure. The Practical Journal of Integrating Chinese with Modern Medicine 1998;11(8):704.

Google Scholar

Dian‐Hong Li, Ning Chen, Hui Li, Hong‐Yu Liang. The effect of Shengmai injection for heart failure of chronic plumonary heart disease. Modern Journal of Integrated Chinese Traditional and Western Medicine 2003;12(2):158‐9.

Google Scholar

Wei‐Fen Li, Jun Lan, Yin Liu, Yu‐Lin Chen, Hong‐Zhang Huang. The effect of Shengmai injection on B type natriuretic peptide for congestive heart failure. Chinese Journal of Integrated Traditional and Western Medicine 2004;24(7):620.

Google Scholar

Yu‐Xiu Liao. The effect of Shengmai injection for 45 patients with heart failure. Guangxi Medical Journal 1996;18(4):4389.

Google Scholar

Li Ma, Lan Yang, Tian‐Duo Chen, Pei‐Jie Li. Influence of large amount of shengmai injection on blood coagulation in patients with chronic heart failure. Chinese Journal of Integrated Traditional and Western Medicine 2003;23(4):275‐7.

Jun‐Qing Mao. The effect of Shengmai plus grain for 32 patients with heart failure of pulmonary heart disease. Tianjin Journal of Traditional Chinese Medicine 1998;15(4):164‐5.

Google Scholar

Jing‐Yuan Mao, Heng‐He Wang, Qiang Wang, Qi‐Mei Zhang, Hong Li, Yun Zhang, Yan‐Ping Chang, Hui‐Xuan Wu, Ying Zheng, Yu Zhang. The mechanism of Shengmai injection for congestive heart failure. Traditional Chinese Drug Research & Clinical Pharmacology 2003;23(5):347‐50.

Google Scholar

Jing‐Yuan Mao, Wei‐Ren Xu, Heng‐He Wang, Qiang Wang, Yun Zhangm Yan‐Ping Chang, Hong Li, Ying Zheng, Hui‐Xuan Wu, Yu Zhang. Clinical study on the effect of Shengmai injection on serum concentration and pharmacokinetic parameters of digoxin in patients with congestive heart failure. Chinese Journal of Integrated Traditional and Western Medicine 2003;23(5):347‐50.

Jie Sun, Feng Huang, Li‐Hua Chen. The effect of Shengmai injection for congestive heart failure. Integrated Traditional Chinese and Western Medicine in Practice of Critical Care Medicine 1998;5(9):414‐6.

Google Scholar

Er‐Wen Tang, You‐Ru Zeng. The effect of Shengmai injection for 33 patients with congestive heart failure. Youjiang Medical Journal 2001;29(1):10‐1.

Google Scholar

Fu‐An Wang, Jin‐Qian Wang. The effect of Shengmai injection for congestive heart failure. New Drugs and Clinical Remedies 1997;16(2):113‐4.

Google Scholar

Zhi‐Yuan Wang, Xiao‐Yan Hu, Fei‐Zhou Liu. Clinical observation of Shengmai injection for congestive heart failure. Lishizhen Medicine and Materia Medical Research 2004;15(6):353.

Google Scholar

Ya‐Chen Zhang, Rui‐Ming Chen, Mei‐Hua Zhao, Bao‐Jing Lu, Ye‐Zhi Rong. Effect of Shengmai Injection on hemodynamics in patients with dilated cardiomyopathy. Chinese Journal of Integrated Traditional and Western Medicine 2002;22(4):277‐9.

Referencias de los estudios excluidos de esta revisión

Ir a:

estudios incluidos
estudios a la espera de valoración
otras referencias

Ming Chen, Si‐Rong Zheng. Shengmai injection for 29 patients with heart failure of pulmonary heart disease. Fujian Journal of Traditional Chinese Medicine 2000;31(6):33‐4.

Google Scholar

Gen‐Qun Feng. Shengmai injection and phentolamine for 30 patients with heart failure. Inner Mongol Journal of Traditional Chinese Medicine 2002;21(5):11‐2.

Google Scholar

Jin‐Zhi Liu. Integration of traditional and western medicine for 35 patients with chronic refractory heart failure. Journal Of Tianjin College of Traditional Chinese Medicine 1999;18(2):21‐2.

Google Scholar

Zhen‐Zhao Mo, Xiao‐Dong Peng, Jing‐Quan Dou. The effect of Shengmai injection on heart function change in chronic heart failure. The Journal of Practical Medicine 1996;12(5):310‐1.

Google Scholar

Yan‐ping Qiu. The of effect of Shengmai complementary treatment for heart failure of pulmonary heart disease. Acta Academiae Medicinae Suzhou 1999;19(2):152.

Google Scholar

Dong Sun, Shu‐Ling Yang, Heng‐Mei Yin. The effect of Shengmai injection for 50 patients with heart failure of pulmonary heart disease. China Pharmaceuticals 1999;8(7):19‐20.

Google Scholar

Chao‐Hui Wang, Jin‐Zhi Zhang, Yuan‐Shu Tu, Yin‐Huan Zhang. The effects of Shengmai injection for cardiac insufficiency on clinical status and hemodynamic. The Journal of Clinical Cardiology 1994;10(3):190‐1.

Google Scholar

Yu Wang, Jing Su. The clinical analysis of Shengmai injection plus usual western drugs for 100 patients with aged congestive heart failure. Chinese Journal of Gerontology 2003;23(12):868.

Google Scholar

Qiong‐Lin Xiao. Integration of traditional and western medicine for 32 patients with refractory heart failure. Hunan Journal of Traditional Chinese Medicine 2004;20(6):32.

Google Scholar

Si‐Lin Yang. Integration of traditional and western medicine for 52 patients with refractory heart failure. New Journal of Traditional Chinese Medicine 2001;33(9):37‐8.

Google Scholar

Zhi‐Jiong Zhang, Zhen‐Hua Wang, Shu‐Min Yu, Hong‐Yan Zhou, Ming Sun. The effect of Shengmai injection on hemodynamic for heart failure of dilated cardiomyopathy. Bulletin of Hunan Medical University 1990;15(2):153‐6.

Google Scholar

Yi Zhao, Yan Zhao. The clinical observation of Shengmai injection for aged heart failure. Yunnan Journal of Traditional Chinese Medicine and Materia Medica 1998;19(3):13‐4.

Google Scholar

Chun‐Li Zhao. The clinical observation of Shengmai injection for 45 patients with heart failure of pulmonary heart disease. West China Journal of Pharmaceutical Science 1998;13(2):131‐2.

Google Scholar

San‐Ming Zhao, Chun‐Feng Guo. The effect of integration of traditional and western medicine on EF value change for heart failure. Journal of Shanxi Medical University 2000;31(3):227.

Google Scholar

Li‐Na Zheng. The effect of Shengmai powder for 6 patients with cardiogenic shock and acute left heart failure. Hunan Medical Journal 1996;13(1):51.

Google Scholar

Referencias de los estudios en espera de evaluación

Ir a:

estudios incluidos
estudios excluidos
otras referencias

Chen Tao. Shengmai and glonoin for congestive heart failure. Sichuan Medical Journal 2003;24:268.

Google Scholar

Ding Qi‐Zhu. Shengmai injection for heart failure. Journal of Chinese Traditional Medicine Acute Symptom 2005;14:440‐1.

Google Scholar

Fan Yu‐Hua, Xu Gui‐Rong, Zhu Chuan‐Yun. Shengmai injection for 34 patients with aged heart failure. Chinese Journal of Traditional and Western Medicine 2004;5:928‐9.

Google Scholar

Fang J, Jiang J, Luo DC. Effect of sheng mai decoction on left ventricular function in patients with coronary heart disease. A randomized double blind, placebo controlled cross over trial. Chinese Journal of Internal Medicine 1987;26:403‐6.

Feng Guo‐Wen. Shengmai injection and digoxin for congestive heart failure. Journal of Emergency in Traditional Chinese Medicine 2003;12:34.

Google Scholar

Gu Guang‐Nian, Zhao Xiao‐Hua, Zhang Feng‐Xia. Shengmai injection for 80 patients with congestive heart failure. Youjiang Medical Journal 2004;32:151.

Google Scholar

Jiang J, Fang J, Luo D. Effectiveness of Sengmai oral liquid on left ventricle function and exercise tolerance for dilated cardiomyopathy. Chinese Journal of Cardiology 1988;16(2):65‐7.

Jiang Wei, Ruan Xin‐Min, Lin Yu, et al. The effects of Shengmai for patients with coronary artery bypass grafting. Journal of Liaoning Chinese Medicine 2005;32:869‐71.

Google Scholar

Li Cun‐Zhou, Zhu Gui‐Xiang. Clinical observation on Shengmai injection and dobutamine for acute myocardial infarction with heart failure. Journal of Emergency in Traditional Chinese Medicine 2003;12:429.

Google Scholar

Lu Bao‐jing, Zhang Ya‐Chen, Zheng Hong‐Chao, et al. Effect of Sheng Mai injection on cardiac function assessed by ventriculography in the patients with coronary artery disease. Chinese Journal of Clinical Pharmacy 2005;14:207‐10.

Google Scholar

Miao Yu‐Mei, Chen Feng‐Ling, Ma Ming‐Hui. The effects of Shengmai for acute myocardial infarction. Chinese Medicine of Factory and Mine 2005;18:363‐4.

Google Scholar

Ni Bin, Jia Lan, Chen Hong. Shengmai injection for chronic congestive heart failure. Chinese Journal of Current Practical Medicine 2004;3:72.

Google Scholar

Tang Chuan‐Su, Luo Gui‐Quan, Zhou Ming‐Gang. The effects of Shengmai for chronic heart failure. Modern Journal of Integrated Traditional Chinese and Western Medicine 2005;14(18):2395.

Google Scholar

Wan Yun‐Li, Zhang Gui‐Hua. Observation on therapeutic effects of Shengmai injection on treatment of congestive heart failure. Jilin Journal of Traditional Chinese Medicine 2004;24:19‐20.

Google Scholar

Wang Shi‐Xiong, Li Guang‐Ming, Xiang Chang‐Qing. Shengmai capsule for chronic systolic heart failure. Journal of Chinese Modern Clincial Medicine 2004;2:1873‐4.

Google Scholar

Wang Shong‐Hua, Xiao Ping. The effects of Shengmai injection for 42 patients with chronic systolic heart failure. Journal of Shandong Medicine and Drugs 2005;45:31.

Google Scholar

Yan Shan‐Fu. Shengmai San for acute myocardial infarction. Journal of Chinese Modern Clinical Medicine 2005;4:23‐5.

Google Scholar

Yang Quan, Ma Min, Lian Shi‐Gang, et al. Dose‐effect study of Shengmai injection used for congestive heart failure. West China Medical Journal 2005;20:710.

Google Scholar

Zhang Ya‐Chen, Zhao Mei‐Hua, Lu Bao‐Jing, et al. Effects of shengmai injection in the treatment of acute myocardial infarction with left ventricular dysfunction. Journal of Shanghai Second Medical University 2004;24:692.

Google Scholar

Zhang Pei‐Yun, Shen Xiao‐Ming, Tao Zhi‐Qi, et al. Shengmai for refractory heart failure. Research and Clinical Practice of Chinese Traditional Medicine 2004;2:36‐7.

Google Scholar

Zhao Lian‐Xi, Tian Qin. Shengmai injection for 46 patients with chronic heart failure. (Non‐formal publication journal, no name of journal in English) 2004, (97):11573.

Google Scholar

Zheng Kun‐Hua, Jia Lian‐Wang. Curative effect evaluation of Shengmai injection on congestive heart failure in aged. Journal of Modern Integrated Tranditinal Chinese and Western Medicine 2005;14:716‐7.

Google Scholar

Zhu Gui‐Yue, Xie Jian, Zhu Xing‐Lie, et al. Change of thyroid hormone in patients with congestive heart failure and intervention with Shengmai injection. Shanghai Journal of Traditional Chinese Medicine 2004;38:11‐13.

Google Scholar

Referencias adicionales

Ir a:

estudios incluidos
estudios excluidos
estudios a la espera de valoración

Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation2005; Vol. 112, issue 12:e154‐235.

Google Scholar

American Heart Association. Heart Disease and Stroke Statistics: 2005 Update. Dallas, Texas: American Heart Association, 2005.

Akera T, Baskin SI, Tobin T, Brody TM. Ouabain: temporal relationship between the inotropic effect and the in vitro binding to, and dissociation from, (Na + + K + )‐ activated ATPase. Naunyn‐Schmiedebergs Archives of Pharmacology 1973;277:151‐62.

Alderson P, Green S, Higgins JPT. Assessment of study quality. Cochrane Reviewers’ Handbook 4.2.2 [updated December 2003] Section 6 http://www.cochrane.org/resources/handbook/hbook.htm [accessed 31st January 2004]2003.

Google Scholar

Society of Cardiology, Chinese Medical Association. Retrospective investigation of hospitalized patients with heart failure in some parts of China in 1980, 1990 and 2000. Chinese Journal of Cardiology 2002;30(8):450‐4.

Society of Cardiology, Chinese Medical Association. Guideline on treatment of chronic systolic heart failure. Chinese Journal of Cardiology 2002;30(1):7‐23.

Deng X, Luo D. Effectiveness of Sengmai decoction on left ventricle function, exercise tolerance and oxygen free radicals for patients of angina pectoris. Chinese Journal of Internal medicine 1992;31:113‐5.

Google Scholar

Faris R, Flather MD, Purcell H, Poole‐Wilson PA, Coats AJS. Diuretics for heart failure. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD003838.pub2]

Gheorghiade M, Ferguson D. Digoxin: a neurohormonal modulator in heart failure?. Circulation 1991;84:2181‐6.

Gu D, Huang G, He J, et al. Investigation of prevalence and distributing feature of chronic heart failure in Chinese adult population. Chinese Journal of Cardiology 2003;31(1):3‐6.

Google Scholar

Hood WB, Dans AL, Guyatt GH, Jaeschke R, McMurray JJV. Digitalis for treatment of congestive heart failure in patients in sinus rhythm. Cochrane Database of Systematic Reviews 2004, Issue 2. [DOI: 10.1002/14651858.CD002901.pub2]

Li PC, Poon T, Ko KM. Schisandra chinensis‐dependent myocardial protective action of Sheng‐Mai‐San in rats. American Journal of Chinese Medicine 1996;24:255‐62.

Li Qin, Liu Hong. The pharmacological mechanism and clinical application of Shengmai injection. Medical Recapitulate 2005;11(10):950‐2.

Google Scholar

Li Wen‐Sheng. Adverse effects of Shengmai injection and reasons. Medicine World 2006;8(4):109‐10.

Google Scholar

Rong Y, Wen W, Yao M, Han Y. Role of oxygen in myocardial reoxygenation injury and the protective effect of Shengmai San. Journal Shanghai Second Medical University 1988;2(z1):11‐5.

Google Scholar

Rong Y, Wen W, Ful L, Han Y. Protective effect of Sheng Mai San on adriamycin‐induced cardiotoxicity ‐ an experimental study. Journal Shanghai Second Medical University 1989;3(z1):39‐43.

Google Scholar

Shanghai Investigation Group of Heart Failure. The evolving trends in the epidemiologic factors and treatment of hospitalized patients with congestive heart failure in Shanghai during the years 1980, 1990, 2000. Chinese Journal of Cardiology 2002;30(1):24‐6.

Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary ( update 2005). European Heart Journal 2005;26:1115‐40.

Takano H, Hasegawa H, Nagai T, Komuro I. Implication of cardiac remodeling in heart failure: mechanisms and therapeutic strategies. Internal Medicine 2003;42(6):465‐9.

Wang F, Wang J, Zhou X. The effectiveness of Shengmai injection for 50 congestive heart failure patients. West China Journal of Pharmaceutical Sciences 1997;12(4):275.

Google Scholar

Wang X, Yu Q, Yang C, et al. Comparative study on the eradicating effects of oxygen free radicals by using three forms of Shengmai preparation. Hunan Medicine 2002;19(2):83‐4.

Google Scholar

Yu G, Tang S, Peng Y, et al. Antioxidative effect of Shengmai injection on the myocardium injury induced by adriamycin in rats. Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2000;7(2):94‐5.

Google Scholar

Zhang S, Guo H, Qin Y, et al. A clinical study of Shenmai injection for congestive heart failure. Acta Chinese Medicine and Pharmacology 2000;28(3):12‐3.

Google Scholar

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

estudios excluidos

Cen 1999

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 82 patients (42 in Shengmai group, M/F 34/8, mean age 69 +/‐6.0 years; 40 in control group, M/F 33/7, mean age 70.2 +/‐ 8 years) Setting: inpatients Diagnostic criteria: NYHA class Shengmai goup: CHD/PHD/hypertensive heart disease/RHD: 20/8/8/6; control group: CHD/PHD/hypertensive heart disease/RHD/DCM: 18/6/9/6/1 Exclusion criteria: electrolyte disturbance,acute myocardial infarction,recently use the drugs which influence cardiac ventricle (not include digitalis)
Interventions	Shengmai group: shengmai injection (100mL + 5% glucose solution 150mL intravenously daily) + usual treatment Control group: usual treatment Co‐interventions (usual treatment): digoxin (maintenance dosage), furosemide and vasodilator Treatment duration: 20 days
Outcomes	Heart function improvement >1 class: 81% in Shengmai group; 55% in control group QT dispersion by electrocardiogram: before treatment: 79.19 +/‐ 21.98 in shengmai group, 77.68+/‐ 22.12 in control group; after treatment: 48.12 +/‐ 23.22 in shengmai group, 64.48 +/‐ 49.42 in control group JT dispersion of electrocardiogram : before treatment: 76.13 +/‐ 22.73 in shengmai group, 75.00 +/‐ 23.72 in control group; after treatment: 44.22 +/‐ 22.52 in shengmai group, 63.19 +/‐18.31 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Cheng 2001

Methods	Quasi‐random (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 220 patients (110 in shengmai group, M/F76/34, mean age 56 years, mean duration of heart failure:9.7 years, degree of right heart failure: I/ II/ III: 40/54/16 arrhythmia: 26; 110 in control group, M/F 68/42, mean age 57.6 years, mean duration of heart failure: 9.5 years, degree of right heart failure: I/ II/ III: 44/50/16 arrhythmia: 28) Setting: inpatients Diagnostic criteria of PHD: PHD based on national PHD academic conference criteria in 1997 Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Suzhong, the proportion from three herbs: Radix ginseng rubra, Radix ophiopogonis, Schisandra chinensis is 1:3.12:1.56) 40 to 60mL + 5% glucose solution 250˜500mlLintravenously daily) + co‐interventions Control group: co‐interventions Co‐interventions: anti‐infection; expelling sputum; oxygen therapy; spasmolysis; diuretic; cardiotonic Treatment duration:10 to 15 days multiply 1.5
Outcomes	Death: 3 in shengmai group, 12 in control group Heart function improvement <1 class: 12 in shengmai group, 47 in control group Outcomes were measured in 1 to 3 months after discharge from hospital Serum enzyme
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

Gao 2001

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 12 patients (58 in shengmai group, M/F 41/17, 54 in control group, M/F 40/14, mean age 66.8 years) Setting: inpatients Diagnostic criteria of PHD: PHD based on national PHD academic conference criteria in 1997 Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Suzhong, 25 mL+ 5% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: inhaling oxygen; antibiotic; beta2 excitomotor; aminophylline; diuretic; expelling sputum Treatment duration: 10 days
Outcomes	Symptoms and sign no improvement or worsening of heart failure; 4 in shengmai group, 12 in control group PaO2 change after treatment: 2.6 +/‐ 0.7 KPa in shengmai group, 2.0 +/‐ 0.6 KPa in control group PaCO2 change after treatment: ‐2.8 +/‐ 0.6 KPa in shengmai group, ‐1.8 +/‐ 0.8 KPa in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

He 2001

Methods	Quasi‐randomised (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 80 patients (40 in Shengmai group, M/F 28/12, mean age 50 years; 40 in control group, M/F 26/14, mean age 48 years) Setting: inpatients Diagnostic criteria of heart failure: NYHA class Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Suzhong, from three herbs: Radix ginseng rubra, Radix ophiopogonis, Schisandra chinensis) 40 to 60 mL + 5% glucose solution 250 mL intravenously daily + co‐intervention Control group: co‐intervention Co‐interventions: salt restriction; diuretic; digitalis; vasodilator Treatment duration: 14 days
Outcomes	Heart function improvement < I class: 5 in shengmai group, 12 in control group Outcomes were measured at the end of treatment
Notes	Single blinding: participants No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

He 2004

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 60 patients (32 in shengmai group, M/F 18/14, mean age 43 years; 28 in control group, M/F 15/13, mean age 42 years), heart function: class 2/class 3/class 4:8/34/18; CHD/hypertensive heart disease/DCM/RHD:21/15/12/12 Setting: inpatients Diagnostic criteria of heart failure: NYHA class Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Huaxi, 20 to 40 mL + 5% glucose solution 250 mL intravenouly daily) + co‐intervention Control group: co‐intervention Co‐intervention: cardiotonic, diuretic, vasodilator Treatment duration: 14 days
Outcomes	Heart function improvement < class 1: 3 in shengmai group, 7 in control group Exercise tolerance test: 12 min +/‐ 3min in shengmai group, 6+/‐ 3min in control group Heart rate multiply systolic blood press: no difference Activity of FMD of brachial artery: before treatment: 3.5 +/‐ 3.1 in shengmai group, 3.6 +/‐ 3.1 in control group; after treatment: 9.6 +/‐ 3.2 in shengmai group, 4.2 +/‐ 2.8 in control group The outcomes were measured at the end of treatment.
Notes	Single blinding: participants Activity of FMD of brachial artery assessed blindly No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Hu 1998

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 80 patients (36 in shengmai group, M/F 29/7, mean age 56 years; 44 in control group, M/F 35/9, mean age 58 years) Setting: inpatients Diagnostic criteria: ischemic heart disease diagnosis based on WHO criteria; heart failure diagnosis based on Killip heart function class Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Suzhong, proportion from three herbs: Radix ginseng rubra, Radix ophiopogonis, Schisandra chinensis is 1:3.12:1.56. 10 mL + 5% glucose solution 200 mL intravenously every 12 hours) + co‐intervention Control group: co‐intervention Co‐interventions: sodium nitroprusside from 6.25ug/min to 50‐100ug/min based on blood pressure, continuing as intravenous drip for 24 hours Treatment duration: 10 days
Outcomes	Heart function improvement < class 1: 2 in shengmai group, 12 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Li 1998a

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 64 patients (30 in shengmai group, M/F 20/10, mean age 69.4 years; 34 in control group, M/F 22/12, mean age 72.2 years) Setting: inpatients Diagnostic criteria: PHD diagnosed based on national PHD academic conference criteria in 1980 Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Huaxi, 40 mL + 5% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: diuresis; cardiotonic; antibiotic Treatment duration: 10 days.
Outcomes	Heart function improvement <class 1: 4 in shengmai group, 12 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Li 1998b

Methods	Quasi‐random (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 82 patients (62 in shengmai group, M/F 40/22, mean age 62 +/‐ 12 years, duration of heart failure 1‐14 years, heart function class 2/3/4: 16/24/22, RHD/ CHD/PHD 26/30/6; 20 in control group, M/F 14/6, mean age 56 +/‐ 12 years, duration of heart failure 1‐12 years, heart fuction class 2/3/4: 4/8/8, RHD/ CHD/PHD 8/10/2) Setting: inpatients Diagnostic criteria of heart failure: textbook of medicine, NYHA class Exclusion criteria: none
Interventions	Shengmai group: shengmai injection (agent: Huaxi, 30‐50 mL + 10% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: diuretic, vasodilator, inhale oxygen ,antibiotic, cardiotonic Treatment duration: 15 days
Outcomes	Heart function improvement <class 1: 6 in shengmai, 6 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

Li 2003a

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 154 patients (77 in shengmai group, M/F 42/35, mean age 63.5 years, NYHA class 3/4: 50/27; 77 in control group, M/F 40/37, mean age 63 years, NYHA class 3/4: 52/25) Setting: inpatients Diagnostic criteria: PHD diagnosis based on national third PHD academic conference criteria Exclusion criteria: not state
Interventions	Shengmai group: shengmai injection (agent Suzhong, 30 mL + 5% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: diuretic, digitalis, vasodilator, inhale oxygen, antibiotic Treatment duration: 14 days.
Outcomes	Heart function improvement <class 1: 6 in shengmai, 25 in control group Outcomes were measured at the end of treatment
Notes	Single blinding: participants No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Li 2004

Methods	Quasi‐random (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 57 patients (29 in shengmai group, M/F 16/13, mean age72.96 years, mean duration of heart failure 7.5 years, heart fuction class 3/4: 11/18, CHD/hypertension heart disease/presbycardia 18/10/1; 28 in control group, M/F 16/12, mean age 73.79 years,mean duration of heart failure 7.9 years, heart fuction class 3/4: 8/20, CHD/hypertension heart disease/DCM 19/8/1) Setting: inpatients Diagnostic criteria: heart faiure diagnosis based on WHO criteria. Exclusion criteria: acute inflammation, acute myocardial infarction, chronic bronchitis, chronic liver disease, renal inadequacy.
Interventions	Shengmai group: shengmai injection (agent: Hehuang, shengmai injection/mL: Ranax ginseng 1 g, Radix ophiopogonis 3.12 g, Fructus schisandra chinensis1.56 g 60 mL + 5% glucose solution 250‐500 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: diuretic, ACE inhibitor, cardiotonic Treatment duration: 15 days
Outcomes	B‐type natriuretic peptide: before treatment: 928.17+/‐534.46 in shengmai group, 934.35 +/‐570.54 in control group; after treatment: 167.56 +/‐96.88 in shengmai group, 383.83 +/‐ 226.69 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

Liao 1996

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 90 patients (45 in shengmai group, M/F 30/15, mean age 65 years, mean duration of heart failure 8 years, RHD/CHD/PHD/DCM/hypertension heart disease/ thyroid heart disease/congenital heart disease 4/20/14/2/2/2/1, degree of heart failure 1/2/3: 8/15/22; 45 in control group, M/F 27/18, mean age 66 years, mean duration of heart failure 8 years, RHD/CHD/PHD/DCM/hypertension heart disease/ thyroid heart disease 5/18/13/5/2/2, degree of heart failure 1/2/3: 9/18/18) Setting: inpatients Diagnostic criteria: heart failure diagonsis based on a textbook of Medicine. Exclusion criteria: not state
Interventions	Shengmai group: shengmai injection (50 mL + 5%glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: diuretic, cardiotonic, vasodilator, inhale oxygen Treatment duration: 10 days
Outcomes	Heart function improvement <class 1: 1in Shengmai, 8 in control group The outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Ma 2003

Methods	Quasi‐random (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 60 patients (30 in shengmai group, M/F 17/13, mean age 65.27 years, mean duration of heart failure 5.45 years, CHD/RHD/hypertension heart disease/DCM 22/3/3/2, NYHA class 2/3/4: 7/16/7; 30 in control group, M/F 15/15, mean age 67.33 years, mean duration of heart failure 6.36 years, CHD/RHD/hypertension heart disease 25/2/3, NYHA class 2/3/4: 6/16/8) Setting: inpatients Diagnostic criteria of heart failure: NYHA class Exclusion criteria: atrial fibrillation, liver and renal diseases, infection, diabetes, malignant tumor, respiratory system diseases
Interventions	Shengmai group: shengmai injection (agent: Huaxi, from three herbs/10mL: Radix ginseng rubra 1 g, Radix ophiopogonis 3.12 g, Schisandra chinensis1.56 g. 100mL + 5% glucose solution 200mL iv gtt qd) + co‐intervention Control group: co‐intervention Co‐interventions: captopril 25‐50 mg 3 times a day; digoxin 0.25‐0.5 mg daily; metoprolol 6.25‐25 mg 3 times a day, isosorbide mononitrate 20 mg twice daily orally; Treatment duration: 14 days
Outcomes	Heart function improvement < class 1: 2 in shengmai, 10 in control group Plasma P‐selectin change: ‐1.63 +/‐0.3 in shengmai group, ‐0.88 +/‐0.35 in control group von Willebrand's factor change: ‐11.57 +/‐1.58 in shengmai group, ‐3.81 +/‐1.05 in control group D‐dimer change: ‐0.09 +/‐0.01 in shengmai group, ‐0.08 +/‐0.03 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

Mao 1998

Methods	Randomised controlled trial
Participants	Ethnic: Chinese 62 patients (32 in shengmai group, M/F 28/4, mean age 68 years, duration of heart failure 6‐40 years; 30 in control group, M/F 25/5, mean age 67 years, duration of heart failure 5‐41 years) Setting: inpatients Diagnostic criteria: PHD diagnosis based on national second PHD academic conference criteria in 1980 Exclusion criteria: not state
Interventions	Shengmai group: shengmai injection (agent: Yibing, 100 mL + 5% glucose solution 250‐500 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: traditional chinese drugs Treatment duration: 14 days multiply 1‐2
Outcomes	Heart function improvement < class 1: 2 in shengmai, 9 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Mao 2003

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 40 patients (10 in shengmai A1 group, 10 in shengmai A2 group, 10 in shengmai A3 group, 10 in control A group); 40 patients (10 in shengmai B1 group, 10 in shengmai B2 group, 10 in shengmai B3 group, 10 in control B group). Setting:inpatients Diagnostic criteria: heart failure diagnosis based on Framingham and Boston criteria, heart function class based on NYHA class Inclusion criteria: heart failure; age 41‐70 years; heart failure class 2‐3; not taking digitalis or drugs affecting the metabolisation of digoxin within 1 week; liver and kidney fuction were normal, normal electrolyte Exclusion criteria: acute myocardial infarction, or acute respiratory insufficiency of PHD, or serious mitral stenosis in sinus rhythm, or HCM with obstruction, diabetes, hyperthyoidism
Interventions	Shengmai A1, A2, A3 groups: shengmai injection (agent: Yibing, 20, 40, 60 mL intravenously daily ) + co‐intervention A Control A group: co‐intervention A Co‐interventions A: digoxin (0.25 mg + 5% glucose solution 40 mL, intravenously daily) + polarized solution 200 mL intravenously daily Shengmai B1, B 2, B3 groups: shengmai injection (agent: Yibing 20, 40, 60 mL intravenously daily) + co‐intervention B Control B group: co‐intervention B Co‐interventions B: polarized solution 200 mL intravenously daily Treatment duration:14 days.
Outcomes	Heart function improvement < class 1: 7/60 in all shengmai, 2/20 in control group. Serum TNFa: before treatment: 1.44 +/‐0.8 in shengmai A1 group, 1.53 +/‐0.73 in shengmai A2 group, 1.52 +/‐0.66 in shengmai A3 group, 1.54 +/‐0.68 in control A group; after treatment: 0.71 +/‐0.52 in shengmai A1 group, 0.63 +/‐0.29 in shengmai A2 group, 0.59 +/‐0.36 in shengmai A3 group, 1.2 +/‐0.65 in control A group Serum EDLF: before treatment: 0.17 +/‐0.12 in shengmai B1 group, 0.15 +/‐0.08 in shengmai B2 group, 0.16 +/‐0.09 in shengmai B3 group, 0.18 +/‐0.06 in control B group; after treatment: 0.29 +/‐0.14 in shengmai B1 group, 0.32 +/‐0.11 in shengmai B2 group, 0.37 +/‐0.1 in shengmai B3 group, 0.14 +/‐0.06 in control B group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Sun 1998

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 52 patients (27 in shengmai group, M/F 15/12, mean age 55 years, CHD/RHD/hypertension heart disease/PHD 11/7/5/4, NYHA class 3/4: 12/15; 25 in control group, M/F 14/11, mean age 57 years, CHD/RHD/hypertension heart disease/PHD 9/7/6/3, NYHA class 3/4: 11/14) Setting: inpatients Diagnostic criteria: not stated Exclusion criteria: not stated
Interventions	Shengmai group: shengmai injection (agent: Huaxi, 50 mL + 10% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: nitroglycerol (10 mg + 10% glucose solution 250 mL intravenously 15ug /min daily) + diuretic, oxygen therapy ,antibiotic, cardiotonic agent Treatment duration: 10 days
Outcomes	Heart function improvement < class 1: 2 in shengmai, 7 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Tang 2001

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 66 patients (33 in shengmai group, M/F 20/13, mean age 65.3 years, mean duration of heart failure 3˜12 years, CHD/RHD/PHD/hypertension heart disease/DCM/ 12/9/7/3/2, NYHA class 3/4: 19/14; 33 in control group, M/F21/12, mean age 64.7 years, mean duration of heart failure 2˜10 years, CHD/RHD/PHD/hypertension heart disease/DCM/ 11/10/6/4/2) Setting: inpatients Diagnostic criteria: heart failure diagnosis based on "Medicine", heart function criteria based on NYHA class Exclusion criteria: not state
Interventions	Shengmai group: shengmai injection (20 mL + 10% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: cardiotonic agent, diuretic, vasodilator Treatment duration: 14 days
Outcomes	Heart function improvement < class 1: 3 in shengmai, 11 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Wang 1997a

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 100 patients (50 in shengmai group, M/F 28/22, mean age 50years, RHD/CHD/DCM 25/15/10, NYHA class 2/3/4: 3/31/16; 50 in control group, M/F 26/24, mean age 49 years, RHD/CHD/DCM 26/16/8, NYHA class 2/3/4: 2/33/15) Setting: inpatients Diagnostic criteria: heart function criteria based on NYHA class Exclusion criteria: hypertension
Interventions	Shengmai group: shengmai injection (agent: Huaxi, 60 mL + 5% glucose solution 250 mL intravenously daily) + co‐interventions Control group: co‐interventions Co‐interventions: digoxin 0.125¡«0.25 mg orally daily; hydrochlorothiazide 50¡«100 mg orally daily, isosorbide dinitrate 10 mg , orally 3 or 4 times per day Treatment duration: 14 day
Outcomes	Heart function improvement < class 1: 6 in shengmai, 13 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Wang 2004a

Methods	Quasi‐random (sequence of visit hospital) controlled trial
Participants	Ethnic: Chinese 62 patients (31 in shengmai group, M/F 21/10, mean age 60.5 years, duration of heart failure 7.8 years, heart function class 2/3/4: 8/13/10, CHD/hypertension heart disease/RHD/PHD/DCM 10/8/5/4/4; 31 in control group, M/F 23/8, mean age 59.5 years,duration of heart failure 7.5 years, heart function class 2/3/4: 10/12/9, CHD/hypertension heart disease/RHD/DCM/PHD 8/9/4/5/5) Setting: inpatients Diagnostic criteria: heart failure diagnosis based on Framingham criteria, heart function class based on NYHA class Exclusion criteria: not stated
Interventions	Shengmai group: shengmai injection (agent: Suzhong, 20‐30 mL + 5% glucose solution 250 mL intravenously daily) + co‐intervention Control group: co‐intervention Co‐interventions: cardiotonic agent, diuretic, vasodilator Treatment duration: 14 days
Outcomes	Heart function improvement < class 1: 5 in shengmai, 14 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	High risk	C ‐ Inadequate

Zhang 2002

Methods	Randomized controlled trial
Participants	Ethnic: Chinese 100 patients (50 in shengmai group, M/F 30/20, mean age 58 years, duration of heart failure 4.8 years, heart function class 2/3/4: 10/35/5; 50 in control group, M/F 29/21, mean age 60 years, duration of heart failure 4.9 years, heart fuction class 2/3/4: 10/36/4) Setting: inpatients Diagnostic criteria: heart function class based NYHA class Exclusion criteria: not stated
Interventions	Shengmai group: shengmai injection (agent: Huaxi, from three herbs/10 mL: Panax ginseng 1 g, Ophiopogon japonicus 3.12 g and Schisandra chinensis 1.56 g. 60 mL + 5% GS250 mL iv gtt qd ) + co‐intervention Control group: co‐intervention Co‐interventions: oxygen therapy, digoxin 0.125 mg daily orally (maintenance therapy); hydrochlorothiazide 25 mg twice daily orally, triamterene 50 mg twice daily orally (to interrupt use); isosorbide dinitrate 5 mg 3 times daily orally Treatment duration: 14 days
Outcomes	Heart function improvement < class 1: 8 in shengmai, 20 in control group Hemodynamics: Cardiac output (L/min): before treatment: 3.8 +/‐1.0 in shengmai group, 3.7 +/‐1.5 in control group; after treatment: 5.1 +/‐0.6 in Shengmai group, 4.2 +/‐0.3 in control group Stroke volume (mL): before treatment: 48.9 +/‐6.0 in shengmai group, 45.4 +/‐5.3 in control group; after treatment: 70.4 +/‐3.2 in shengmai group, 62.3 +/‐3.1 in control group. Cardiac index: before treatment: 1.9 +/‐0.2 in shengmai group, 1.9 +/‐0.2 in control group; after treatment: 3.0 +/‐0.2 in shengmai group, 2.3 +/‐0.2 in control group Ejection fraction: before treatment: 0.45 +/‐0.01 in shengmai group, 0.41 +/‐0.02 in control group; after treatment: 0.64 +/‐0.04 in shengmai group, 0.51 +/‐0.02 in control group System vascular resistance (dynseccm‐5): before treatment: 2602 +/‐689 in shengmai group, 2660 +/‐638 in control group; after treatment: 1886 +/‐896 in shengmai group, 2432 +/‐386 in control group Left ventricular minor axis shortened rate: before treatment: 10.2 +/‐4.1 in shengmai group, 12.2 +/‐3.2 in control group; after treatment: 15.9 +/‐3.5 in shengmai group, 14.0 +/‐3.0 in control group Ventricular wall thickened rate: before treatment: 23.2 +/‐10.3 in shengmai group, 22.1 +/‐16.0 in control group; after treatment: 42.3 +/‐23.1 in shengmai group, 30.6 +/‐15.0 in control group Outcomes were measured at the end of treatment
Notes	No blinding No withdrawal/drop‐outs
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

CHD= coronary heart disease; RHD=rheumatic heart disease; PHD=pulmonary heart disease; DCM=dilated cardiomyopathy; HCM=hypertrophic cardiomyopathy; PaO2=oxygen partial pressure; PaCO2 =carbon dioxide partial pressure; kPa=blood pressure measure unit, 1kPa=7.6mmHg; p.o=by mouth; NYHA=New York Heart Association

Characteristics of excluded studies [ordered by study ID]

Ir a:

estudios incluidos

Study	Reason for exclusion
Chen 2000	Not a randomized or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Feng 2002	Not a randomized or quasi‐randomized controlled trial
Liu 1999	Shengmai + Chinese drug + usual treatment versus usual treatment
Mo 1996	Shengmai versus another drug
Qiu 1999	Outcome reported from 27 patients, but only 20 patients included at entry in control group
Sun 1999	Not a randomized or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Wang 1994	A before‐after study
Wang 2003	Outcome reported from 51 patients, but only 50 patients included at entry in shengmai group
Xiao 2004	Not a randomized or quasi‐randomized controlled trial
Yang 2001	Not a randomized or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Zhang 1990	A before‐after study
Zhao 1998a	Not a randomized or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Zhao 1998b	Not a randomiszd or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Zhao 2000	Not a randomized or quasi‐randomized controlled trial (confirmed by contacting to the author by telephone)
Zheng 1996	Descriptive study

Data and analyses

Open in table viewer

Comparison 1. Shengmai +usual treatment versus usual treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Lack of improvement in heart failure ( NYHA class improved < I class or worsening of heart failure) Show forest plot	18	1606	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.25, 0.40]
Open in figure viewer Analysis 1.1 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 1 Lack of improvement in heart failure ( NYHA class improved < I class or worsening of heart failure).
2 mortality at the end of treatment Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.2 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 2 mortality at the end of treatment.
3 cardiac output (L/min) change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.3 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 3 cardiac output (L/min) change at 2 weeks.
4 stroke volume (ml) change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.4 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 4 stroke volume (ml) change at 2 weeks.
5 cardiac index change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.5 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 5 cardiac index change at 2 weeks.
6 eject fraction change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.6 $Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 6 eject fraction change at 2 weeks.$ Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 6 eject fraction change at 2 weeks.
7 system vascular resistance change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.7 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 7 system vascular resistance change at 2 weeks.
8 left ventricular minor axis shortened rate change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.8 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 8 left ventricular minor axis shortened rate change at 2 weeks.
9 ventricular wall thickened rate change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.9 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 9 ventricular wall thickened rate change at 2 weeks.
10 Exercise time in movement tolerance test at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.10 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 10 Exercise time in movement tolerance test at 2 weeks.
11 heart rate multiply systolic blood press (mmHg) at the end of movement tolerance test at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.11 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 11 heart rate multiply systolic blood press (mmHg) at the end of movement tolerance test at 2 weeks.
12 flow mediated dilation of brachial artery volume change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.12 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 12 flow mediated dilation of brachial artery volume change at 2 weeks.
13 eletrocardiogram QT dispersion change at 20 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.13 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 13 eletrocardiogram QT dispersion change at 20 days.
14 electrocardiogram JT dispersion change at 20 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.14 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 14 electrocardiogram JT dispersion change at 20 days.
15 tumor necrosis factor‐alpha change at 14 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.15 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 15 tumor necrosis factor‐alpha change at 14 days.
16 endogenous digitalis‐like factors change at 14 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.16 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 16 endogenous digitalis‐like factors change at 14 days.
17 Plasma P‐selectin change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.17 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 17 Plasma P‐selectin change at 2 weeks.
18 von Willebrand's factor change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.18 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 18 von Willebrand's factor change at 2 weeks.
19 D‐dimer change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.19 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 19 D‐dimer change at 2 weeks.
20 partial pressure of oxygen increase at 10 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.20 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 20 partial pressure of oxygen increase at 10 days.
21 partial pressure of carbon dioxide decrease at 10 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.21 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 21 partial pressure of carbon dioxide decrease at 10 days.
22 B‐type natriuretic peptide change at 15 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.22 Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 22 B‐type natriuretic peptide change at 15 days.

Figure 1

Funnel plot

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 1 Lack of improvement in heart failure ( NYHA class improved < I class or worsening of heart failure).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 2 mortality at the end of treatment.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 3 cardiac output (L/min) change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 4 stroke volume (ml) change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 5 cardiac index change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

$Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 6 eject fraction change at 2 weeks.$

Analysis 1.6

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 6 eject fraction change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 7 system vascular resistance change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 8 left ventricular minor axis shortened rate change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 9 ventricular wall thickened rate change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 10 Exercise time in movement tolerance test at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 11 heart rate multiply systolic blood press (mmHg) at the end of movement tolerance test at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.12

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 12 flow mediated dilation of brachial artery volume change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.13

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 13 eletrocardiogram QT dispersion change at 20 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.14

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 14 electrocardiogram JT dispersion change at 20 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.15

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 15 tumor necrosis factor‐alpha change at 14 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.16

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 16 endogenous digitalis‐like factors change at 14 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.17

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 17 Plasma P‐selectin change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.18

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 18 von Willebrand's factor change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.19

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 19 D‐dimer change at 2 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.20

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 20 partial pressure of oxygen increase at 10 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.21

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 21 partial pressure of carbon dioxide decrease at 10 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.22

Comparison 1 Shengmai +usual treatment versus usual treatment, Outcome 22 B‐type natriuretic peptide change at 15 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. MEDLINE search strategy

1.shengmai*
2.sengmai
3.senmai
4.MEDICINE CHINESE TRADITIONAL
5.DRUGS CHINESE HERBAL
6.herb*
7.chinese near medicine*
8.chinese near drug*
9.ginseng*
10.liriope
11.schisandra
12.shen next mai
13.sen next mai
14.panax
15.schizandra
16.ophiopogon*
17.#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9
18.#10 or #11 or #12 or #13 or #14 or #15 or #16
19.#17 or #18
20.HEART FAILURE CONGESTIVE
21.heart next failure
22.cardiac next failure
23.VENTRICULAR DYSFUNCTION
24.(ventricular near dysfunction)
25.(cardiac next insufficiency)
26.heart next insufficiency
27.ventric* next fail*
28.#20 or #21 or #22 or #23 or #24 or #25 or #26 or #27
29.#28 and #19

Table 1. MEDLINE search strategy

Ir a la tabla de la revisión

Table 2. EMBASE search strategy

1.shengmai*
2.sengmai
3.senmai
4.MEDICINE CHINESE TRADITIONAL
5.DRUGS CHINESE HERBAL
6.(chinese near medicine*)
7.chinese near drug
8.ginseng*
9.liriope
10.schisandra
11.herb*
12.shen next mai
13.sen next mai
14.panax
15.schizandra
16.ophiopogon*
17.#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9
18.#10 or #11 or #12 or #13 or #14 or #15 or #16
19.#17 or #18
20.HEART FAILURE CONGESTIVE
21.heart failure
22.cardiac failure
23.VENTRICULAR DYSFUNCTION
24.ventricular near dysfunction
25.cardiac insufficiency
26.heart insufficiency
27.ventric* fail*
28.#20 or #21 or #22 or #23 or #24 or #25 or #26 or #27
29.#28 and #19

Table 2. EMBASE search strategy

Ir a la tabla de la revisión

Table 3. AMED search strategy

1.shengmai$
2.sengmai
3.senmai
4.Traditional medicine chinese
5.Drugs chinese herbal
6.herb$
7.chinese near medicine$
8.chinese near drug$
9.ginseng$
10.liriope
11.schisandra
12.shen near mai
13.sen next mai
14.panax
15.schizandra
16.ophiopogon$
17.1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9
18.10 or 11 or 12 or 13 or 14 or 15 or 16
19.17 or 18
20.Heart failure congestive
21.heart next failure
22.cardiac next failure
23.Heart disease
24.ventricular near dysfunction
25.cardiac next insufficiency
26.heart next insufficiency
27.ventric$ next fail$
28.20 or 21 or 22 or 23 or 24 or 25 or 26 or 27
29.19 and 28

Table 3. AMED search strategy

Ir a la tabla de la revisión

Table 4. BIOSIS search strategy

1.shengmai$
2.sengmai
3.senmai
4.MEDICINE CHINESE TRADITIONAL
5.DRUGS CHINESE HERBAL
6.herb$
7.chinese medicine$
8.chinese drug$
9.ginseng$
10.liriope
11.schisandra
12.shen mai
13.sen mai
14.panax
15.schizandra
16.ophiopogon$
17.1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9
18.10 or 11 or 12 or 13 or 14 or 15 or 16
19.17 or 18
20.HEART FAILURE CONGESTIVE
21.heart failure
22.cardiac failure
23.VENTRICULAR DYSFUNCTION
24.ventricular dysfunction
25.cardiac insufficiency
26.heart insufficiency
27.ventric$ fail$
28.20 or 21 or 22 or 23 or 24 or 25 or 26 or 27
29.28 and 19

Table 4. BIOSIS search strategy

Ir a la tabla de la revisión

Table 5. Characteristics of participants

Study	Number	Sex	Average age	Duration of HF	Original disease	Heart Function
Gao 2001	112	M/F 81/31	66.8		PHD 112
Ma 2003	60	M/F 32/28	65‐67	5.4‐6.3 years	CHD/RHD/HBP/DCM 47/5/6/2	II/III/IV 13/32/15
Sun 1998	52	M/F 29/23	55‐57		CHD/RHD/HBP 20/14/11	III/IV 23/29
Zhang 2002	100	M/F 59/41	58‐60	6 months‐8 years	DCM 100	II/III/IV 20/71/9
Cen 1999	82	M/F 67/15	69‐70		CHD/RHD/HBP/DCM/PHD 38/12/17/1/14
He 2004	60		41		CHD/RHD/HBP/DCM 21/12/15/12	II/III/IV 8/34/18
Mao 2003	80					II/III 27/53
Liao 1996	90	M/F 57/33	65‐66	average 8 years	CHD/RHD/HBP/DCM/PHD/others 38/9/4/7/27/5	I/II/III 17/33/40
Cheng 2001	220	M/F144/76	56‐57	average 9.5‐9.7 years	PHD 220
Wang 2004	62	M/F 44/18	59‐60	average 7.5‐7.8 years	CHD/RHD/HBP/DCM/PHD 18/9/17/9/9	II/III/IV 18/25/19
Li 2003	154	M/F 82/72	63		PHD 154	III/IV 102/52
Hu 1998	80	M/F 64/16	56‐58			III/IV 68/10
He 2001	80	M/F 54/26	48‐50
Li 2004	57	M/F 32/25	72‐73	average 7.5‐7.9 years	CHD/HBP/DCM 37/18/2	III/IV 19/38
Wang 1997b	100	M/F 54/46	49‐50		CHD/RHD/DCM 31/51/18	II/III/IV 5/64/31
Li 1998b	64	M/F 42/22	69‐72		PHD 64
Tang 2001	66	M/F 41/25	64‐65	2‐12 years	CHD/RHD/HBP/DCM/PHD 23/19/7/4/13
Li 1998a	82	M/F 54/28	56‐64	1‐14 years	CHD/RHD/PHD 40/34/8	II/III/IV 20/32/30
Mao 1998	62	M/F 53/9	67‐68	5‐41 years

Table 5. Characteristics of participants

Ir a la tabla de la revisión

Table 6. Characteristics of shengmai treatment

Study	Agent	Dose	Form	Duration of treat
Gao 2001		25 mL + 5% GS 250ml/iv gtt qd	injection	10d
Ma 2003	Huaxi	100 mL + 5% GS 200ml/iv gtt qd	injection	14d
Sun 1998	Huaxi	50 mL +1 0% GS 250ml/iv gtt qd	injection	10d
Zhang 2002	Huaxi	60 mL + 5% GS 250ml/iv gtt qd	injection	14d
Cen 1999		100mL + 5% GS 150ml/iv gtt qd	injection	20d
He 2004	Huaxi	20‐40 mL + GS /iv gtt qd	injection	14d
Mao 2003	Yibin	20,40,60 mL + 5% 200 mL polarized solution /iv gtt qd	injection	14d
Liao 1996		50 mL + 10% GS 250 mL/iv gtt qd	injection	10d
Cheng 2001	Suzhong	40‐60 mL + 5% GS 250‐500 mL/iv gtt qd	injection	(10‐15d)*1.5
Wang 2004	Suzhong	20‐30 mL +5% GS 250 mL/iv gtt qd	injection	14d
Li 2003	Suzhong	30 mL +5 % GS 250 mL/iv gtt qd	injection	21d
Hu 1998	Suzhong	10 mL + 5% GS 200 mL/iv gtt q12h	injection	10d
He 2001	Suzhong	40‐60 mL + 5% GS 250 mL/iv gtt qd	injection	14d
Li 2004	Hehuang	60 mL + 5% GS 250‐500 mL/iv gtt qd	injection	15d
Wang 1997b		60 mL +5% GS 250 mL/iv gtt qd	injection	14d
Li 1998b	Huaxi	40 mL /iv gtt qd	injection	10d
Tang 2001		20 mL +10% GS 250 mL/iv gtt qd	injection	14d
Li 1998a	Huaxi	30‐50 mL + 10% GS 250 mL/iv gtt q12h	injection	15d
Mao 1998	Yibin	100 mL +5% GS 250‐500 mL/iv gtt qd	injection	14d*(1‐2)

Table 6. Characteristics of shengmai treatment

Ir a la tabla de la revisión

Comparison 1. Shengmai +usual treatment versus usual treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Lack of improvement in heart failure ( NYHA class improved < I class or worsening of heart failure) Show forest plot	18	1606	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.25, 0.40]

2 mortality at the end of treatment Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 cardiac output (L/min) change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 stroke volume (ml) change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 cardiac index change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

6 eject fraction change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

7 system vascular resistance change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

8 left ventricular minor axis shortened rate change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

9 ventricular wall thickened rate change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

10 Exercise time in movement tolerance test at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

11 heart rate multiply systolic blood press (mmHg) at the end of movement tolerance test at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

12 flow mediated dilation of brachial artery volume change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

13 eletrocardiogram QT dispersion change at 20 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

14 electrocardiogram JT dispersion change at 20 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

15 tumor necrosis factor‐alpha change at 14 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

16 endogenous digitalis‐like factors change at 14 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

17 Plasma P‐selectin change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

18 von Willebrand's factor change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

19 D‐dimer change at 2 weeks Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

20 partial pressure of oxygen increase at 10 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

21 partial pressure of carbon dioxide decrease at 10 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

22 B‐type natriuretic peptide change at 15 days Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

Comparison 1. Shengmai +usual treatment versus usual treatment

Ir a la tabla de la revisión

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Referencias

Referencias de los estudios incluidos en esta revisión

Cen 1999 {published data only}

Cheng 2001 {published data only}

Gao 2001 {published data only}

He 2001 {published data only}

He 2004 {published data only}

Hu 1998 {published data only}

Li 1998a {published data only}

Li 1998b {published data only}

Li 2003a {published data only}

Li 2004 {published data only}

Liao 1996 {published data only}

Ma 2003 {published data only}

Mao 1998 {published data only}

Mao 2003 {published data only}

Sun 1998 {published data only}

Tang 2001 {published data only}

Wang 1997a {published data only}

Wang 2004a {published data only}

Zhang 2002 {published data only}

Referencias de los estudios excluidos de esta revisión

Chen 2000 {published data only}

Feng 2002 {published data only}

Liu 1999 {published data only}

Mo 1996 {published data only}

Qiu 1999 {published data only}

Sun 1999 {published data only}

Wang 1994 {published data only}

Wang 2003 {published data only}

Xiao 2004 {published data only}

Yang 2001 {published data only}

Zhang 1990 {published data only}

Zhao 1998a {published data only}

Zhao 1998b {published data only}

Zhao 2000 {published data only}

Zheng 1996 {published data only}

Referencias de los estudios en espera de evaluación

Chen 2003 {published data only}

Ding 2005 {published data only}

Fan 2004 {published data only}

Fang 1987 {published data only}

Feng 2003 {published data only}

Gu 2004 {published data only}

Jiang 1988 {published data only}

Jiang 2005 {published data only}

Li 2003b {published data only}

Lu 2005 {published data only}

Miao 2005 {published data only}

Ni 2004 {published data only}

Tang 2005 {published data only}

Wan 2004 {published data only}

Wang 2004b {published data only}

Wang 2005 {published data only}

Yan 2005 {published data only}

Yang 2005 {published data only}

Zhang 2004 {published data only}

Zhang 2005 {published data only}

Zhao 2004 {published data only}

Zheng 2005 {published data only}

Zhu 2004 {published data only}

Referencias adicionales

ACC/AHA 2005

AHA 2005

Akera 1973

Alderson 2003

CMA 2002a

CMA 2002b

Deng 1992

Faris 2006

Gheorghiade 1991

Gu 2003

Hood 2004

Li 1996

Li 2005

Li 2006

Rong 1988

Rong 1989