Elisa Gherbesi, Andrea Faggiano, Carla Sala, Stefano Carugo, Guido Grassi, Cesare Cuspidi, Marijana Tadic
{"title":"Myocardial mechanics in anorexia nervosa: a systematic review and meta-analysis of speckle tracking echocardiographic studies.","authors":"Elisa Gherbesi, Andrea Faggiano, Carla Sala, Stefano Carugo, Guido Grassi, Cesare Cuspidi, Marijana Tadic","doi":"10.2459/JCM.0000000000001661","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Clinical complications of anorexia nervosa (AN) include cardiac structural and functional alterations. Available evidence on impaired myocardial deformation in AN patients without overt systolic dysfunction as assessed by left ventricular ejection fraction (LVEF) is scanty and based on a few studies. The aim of the present meta-analysis was to provide comprehensive and updated information on this issue.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE and Cochrane library) to identify eligible studies from inception up to 31 January 2024. Searches were limited to clinical investigations published in English reporting data on left ventricular (LV) mechanics (i.e. global longitudinal strain) in patients with anorexia and controls. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and global longitudinal strain (GLS) was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) by using random-effects models.</p><p><strong>Results: </strong>Five studies including 171 AN and 147 healthy normal-weight individuals were considered for the analysis. Pooled average LVEF values were 63.2 ± 0.4% in the healthy control group and 64.6 ± 1.0% in the AN group (SMD -0.08 ± 0.11, CI: -0.15/0.30, P = 0.51); the corresponding values of GLS were -20.1 ± 0.9% and -20.2 ± 0.9% (SMD 0.07 ± 0.3, CI: -0.46/0.60, P = 0.80). Unlike GLS, apical strain (data from three studies) was higher in AN than in controls (-23.1 ± 1.8 vs. -21.3 ± 1.8; SMD: -0.42 ± 0.17, CI: -0.08/-0.76, P = 0.01).</p><p><strong>Conclusions: </strong>The results of the present meta-analysis do not support the view that myocardial deformation as assessed by GLS is impaired in patients with AN and preserved LVEF. The role of STE in detecting subclinical cardiac damage in this clinical condition deserves to be evaluated in future studies including regional LV strain.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"740-748"},"PeriodicalIF":2.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2459/JCM.0000000000001661","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Clinical complications of anorexia nervosa (AN) include cardiac structural and functional alterations. Available evidence on impaired myocardial deformation in AN patients without overt systolic dysfunction as assessed by left ventricular ejection fraction (LVEF) is scanty and based on a few studies. The aim of the present meta-analysis was to provide comprehensive and updated information on this issue.
Methods: Following the PRISMA guidelines, systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE and Cochrane library) to identify eligible studies from inception up to 31 January 2024. Searches were limited to clinical investigations published in English reporting data on left ventricular (LV) mechanics (i.e. global longitudinal strain) in patients with anorexia and controls. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and global longitudinal strain (GLS) was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) by using random-effects models.
Results: Five studies including 171 AN and 147 healthy normal-weight individuals were considered for the analysis. Pooled average LVEF values were 63.2 ± 0.4% in the healthy control group and 64.6 ± 1.0% in the AN group (SMD -0.08 ± 0.11, CI: -0.15/0.30, P = 0.51); the corresponding values of GLS were -20.1 ± 0.9% and -20.2 ± 0.9% (SMD 0.07 ± 0.3, CI: -0.46/0.60, P = 0.80). Unlike GLS, apical strain (data from three studies) was higher in AN than in controls (-23.1 ± 1.8 vs. -21.3 ± 1.8; SMD: -0.42 ± 0.17, CI: -0.08/-0.76, P = 0.01).
Conclusions: The results of the present meta-analysis do not support the view that myocardial deformation as assessed by GLS is impaired in patients with AN and preserved LVEF. The role of STE in detecting subclinical cardiac damage in this clinical condition deserves to be evaluated in future studies including regional LV strain.
期刊介绍：
Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine.
Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
