Myocardial mechanics in anorexia nervosa: a systematic review and meta-analysis of speckle tracking echocardiographic studies.

IF 2.9 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI:10.2459/JCM.0000000000001661

Elisa Gherbesi, Andrea Faggiano, Carla Sala, Stefano Carugo, Guido Grassi, Cesare Cuspidi, Marijana Tadic

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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.

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神经性厌食症的心肌力学：斑点追踪超声心动图研究的系统回顾和荟萃分析。

背景：神经性厌食症（AN）的临床并发症包括心脏结构和功能的改变。通过左心室射血分数（LVEF）评估，没有明显收缩功能障碍的神经性厌食症患者心肌变形受损的现有证据很少，而且仅基于少数几项研究。本荟萃分析旨在就这一问题提供全面的最新信息：方法：按照 PRISMA 指南，在文献数据库（Pub-Med、OVID、EMBASE 和 Cochrane 图书馆）中进行了系统检索，以确定从开始到 2024 年 1 月 31 日期间符合条件的研究。搜索仅限于用英语发表的、报告厌食症患者和对照组左心室力学（即整体纵向应变）数据的临床研究。采用随机效应模型，以标准化平均差（SMD）和95%置信区间（CI）计算各组间相关超声心动图变量（如LVEF和整体纵向应变（GLS））的统计学差异：分析考虑了五项研究，包括171名AN和147名健康正常体重者。健康对照组的汇总平均 LVEF 值为 63.2 ± 0.4%，AN 组为 64.6 ± 1.0%（SMD -0.08 ± 0.11，CI：-0.15/0.30，P = 0.51）；GLS 的相应值分别为 -20.1 ± 0.9% 和 -20.2 ± 0.9%（SMD 0.07 ± 0.3，CI：-0.46/0.60，P = 0.80）。与 GLS 不同，AN 的心尖应变（来自三项研究的数据）高于对照组（-23.1 ± 1.8 vs. -21.3 ± 1.8；SMD：-0.42 ± 0.17，CI：-0.08/-0.76，P = 0.01）：本荟萃分析的结果并不支持通过 GLS 评估 AN 患者心肌变形并保留 LVEF 的观点。STE在这种临床情况下检测亚临床心脏损伤的作用值得在未来的研究中进行评估，包括区域左心室应变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Medicine 医学-心血管系统

CiteScore

3.90

自引率

26.70%

发文量

189

审稿时长

6-12 weeks

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.