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