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Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and

Elpida Emmanouilidou-Fotoulaki1, Maria Kavga2, Michail Delis3

  • 11st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.

Children (Basel, Switzerland)
|May 1, 2025
PubMed

Insights

Children with celiac disease may have early myocardial dysfunction, detectable by echocardiography. A gluten-free diet did not significantly improve these cardiac markers in this systematic review.

Area of Science:

  • Pediatric Cardiology
  • Gastroenterology
  • Systematic Reviews

Background:

  • Celiac disease is an autoimmune disorder affecting the small intestine.
  • Early detection of subclinical myocardial dysfunction in pediatric celiac disease is crucial.
  • The impact of a gluten-free diet on cardiac function in these patients requires investigation.

Purpose of the Study:

  • To systematically review and meta-analyze early echocardiographic markers of myocardial function in children and adolescents with celiac disease.
  • To compare cardiac function between celiac patients and healthy controls.
  • To assess the effect of gluten-free diet adherence on myocardial function.

Main Methods:

  • Systematic literature search across major electronic databases.
  • Inclusion of 15 studies involving 916 pediatric celiac disease patients and 569 healthy controls.
  • Analysis of conventional and advanced echocardiographic parameters, including fractional shortening and myocardial performance index.

Main Results:

  • A trend toward reduced myocardial function was observed in celiac disease patients across various echocardiographic parameters.
  • Statistical significance was noted in fractional shortening and myocardial performance index.
  • No significant improvement in these cardiac parameters was found after adherence to a gluten-free diet.

Conclusions:

  • Routine cardiovascular examination using echocardiography is recommended for children with celiac disease to detect subclinical myocardial dysfunction.
  • The myocardial performance index shows potential as a non-invasive marker for assessing cardiac function in this population.
  • Further research is needed to confirm the reliability and clinical applicability of echocardiographic markers and to evaluate long-term effects of gluten-free diet compliance.

Keywords:
celiac diseasechildrenmeta-analysismyocardial dysfunctionsystematic review

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