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Updated: Dec 29, 2025
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
Cardiac abnormalities identified with echocardiography in anorexia nervosa: systematic review and meta-analysis
Jodie Smythe1, Claire Colebourn2, Lara Prisco3
1Consultant Intensivist and Anaesthetist, Intensive Care Unit, Royal Berkshire NHS Foundation Trust, UK.
Insights
Anorexia nervosa causes significant cardiac abnormalities, including reduced heart size and function, detectable by echocardiography. Weight restoration shows potential for improving these cardiovascular changes in patients.
Area of Science:
- Cardiology
- Eating Disorders
- Medical Imaging
Background:
- Anorexia nervosa frequently leads to cardiovascular complications, affecting up to 80% of patients.
- Cardiac involvement is a major cause of morbidity and mortality in anorexia nervosa.
Purpose of the Study:
- To systematically review and meta-analyze echocardiographic abnormalities in patients with anorexia nervosa.
- To define the structural and functional cardiac changes associated with anorexia nervosa.
Main Methods:
- A systematic review and meta-analysis of studies identified through Medline, EMBASE, and Cochrane databases.
- Eligibility criteria included anorexia nervosa as the primary eating disorder and cardiac abnormalities.
- Data extraction and quality assessment were performed independently by two reviewers.
Main Results:
- Analysis of 23 studies (960 patients) revealed significant cardiac abnormalities in anorexia nervosa.
- Key findings include reduced left ventricular mass, reduced cardiac output, increased E/A ratio, and a higher incidence of pericardial effusions.
- Trends toward improvement in cardiac function were observed with weight restoration.
Conclusions:
- Anorexia nervosa is associated with identifiable structural and functional cardiac changes on echocardiography.
- Echocardiography may aid in assessing severity and guiding management strategies.
- Further research is needed to determine echocardiography's role in patient management and monitoring treatment effectiveness.
Background:
Anorexia nervosa affects most organ systems, with 80% suffering from cardiovascular complications.
Aims:
To define echocardiographic abnormalities in anorexia nervosa through systematic review and meta-analysis.
Method:
Two reviewers independently assessed eligibility of publications from Medline, EMBASE and Cochrane Database of Systematic Reviews registries. Studies were included if anorexia nervosa was the primary eating disorder and the main clinical association in described cardiac abnormalities. Data was extracted in duplicate and quality-assessed with a modified Newcastle-Ottawa scale. For continuous outcomes we calculated mean and standardised mean difference (SMD), and corresponding 95% confidence interval. For dichotomous outcomes we calculated proportion and corresponding 95% confidence interval. For qualitative data we summarised the studies.
Results:
We identified 23 eligible studies totalling 960 patients, with a mean age of 17 years and mean body mass index of 15.2 kg/m2. Fourteen studies (469 participants) reported data suitable for meta-analysis. Cardiac abnormalities seen in anorexia nervosa compared with healthy controls were reduced left ventricular mass (SMD 1.82, 95% CI 1.32-2.31, P < 0.001), reduced cardiac output (SMD 1.92, 95% CI 1.38-2.45, P < 0.001), increased E/A ratio (SMD -1.10, 95% CI -1.67 to -0.54, P < 0.001), and increased incidence of pericardial effusions (25% of patients, P < 0.01, 95% CI 17-34%, I2 = 80%). Trends toward improvement were seen with weight restoration.
Conclusions:
Patients with anorexia nervosa have structural and functional cardiac changes, identifiable with echocardiography. Further work should determine whether echocardiography can help stratify severity and guide safe patient location, management and effectiveness of nutritional rehabilitation.
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