Key result
Anorexia nervosa shows no link to impaired myocardial deformation on GLS versus healthy controls.
Why the study?
Evidence on impaired myocardial deformation in anorexia nervosa patients without overt systolic dysfunction as assessed by LVEF was scanty and based on few studies.
Is myocardial deformation as assessed by global longitudinal strain impaired in patients with anorexia nervosa and preserved LVEF compared to healthy controls?
Meta-Analysis (n=318)
Is myocardial deformation as assessed by global longitudinal strain impaired in patients with anorexia nervosa and preserved LVEF compared to healthy controls?
Effect estimate: SMD 0.07 (95% CI -0.46/0.60)
Absolute Event Rate: -20.2% vs -20.1%
p-value: p=0.80
This meta-analysis found no evidence that global longitudinal strain is impaired in patients with anorexia nervosa and preserved LVEF, suggesting preserved global myocardial deformation.
Supports preserved GLS in anorexia nervosa with preserved LVEF; leaves open whether regional strain or other parameters detect subclinical dysfunction.
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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Gherbesi et al. (2024) conducted a meta-analysis in Anorexia nervosa (n=318). Anorexia nervosa vs. Healthy normal-weight individuals was evaluated on Global longitudinal strain (GLS) (SMD 0.07, 95% CI -0.46/0.60, p=0.80). Anorexia nervosa was not associated with impaired myocardial deformation as assessed by global longitudinal strain compared to healthy controls (SMD 0.07; 95% CI -0.46/0.60; P=0.80).
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