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

<b>Background/Objectives:</b> This is the first systematic review and meta-analysis investigating early myocardial dysfunction in children/adolescents with celiac disease and the effect of a gluten-free diet by comparing early echocardiographic markers between patients and healthy indivi...

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Main Authors: Elpida Emmanouilidou-Fotoulaki, Maria Kavga, Michail Delis, Evangelia Farmaki, Charalampos Agakidis, Kyriaki Papadopoulou-Legbelou
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/4/441
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author Elpida Emmanouilidou-Fotoulaki
Maria Kavga
Michail Delis
Evangelia Farmaki
Charalampos Agakidis
Kyriaki Papadopoulou-Legbelou
author_facet Elpida Emmanouilidou-Fotoulaki
Maria Kavga
Michail Delis
Evangelia Farmaki
Charalampos Agakidis
Kyriaki Papadopoulou-Legbelou
author_sort Elpida Emmanouilidou-Fotoulaki
collection DOAJ
description <b>Background/Objectives:</b> This is the first systematic review and meta-analysis investigating early myocardial dysfunction in children/adolescents with celiac disease and the effect of a gluten-free diet by comparing early echocardiographic markers between patients and healthy individuals and between compliant and non-compliant celiac disease patients (based on serum antibody titers). <b>Methods:</b> A systematic literature search was conducted across major electronic databases, with data collection extending up to 3 March 2024. <b>Results:</b> In total, 15 studies with 916 children/adolescent patients with celiac disease and 569 healthy individuals were included. Our results showed a trend toward reduced myocardial function in all echocardiographic parameters (conventional and advanced), with statistical significance in fractional shortening and the myocardial performance index. However, these parameters did not differ significantly after adherence to a gluten-free diet. <b>Conclusions:</b> Therefore, we recommend that an examination of the cardiovascular system should be incorporated into the routine investigations of children with celiac disease in order to detect early subclinical myocardial dysfunction based on echocardiography. Although the results of our meta-analysis indicate that the myocardial performance index may serve as a useful, non-invasive marker for assessing myocardial function in children and adolescents with celiac disease, further research is needed in order to confirm its reliability and clinical applicability in this population. The improvement of echocardiographic parameters after long-term compliance to a gluten-free diet is yet to be evaluated.
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spelling doaj-art-fa094dcf3d744cb58ca7560966043fb72025-08-20T03:13:30ZengMDPI AGChildren2227-90672025-03-0112444110.3390/children12040441Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-AnalysisElpida Emmanouilidou-Fotoulaki0Maria Kavga1Michail Delis2Evangelia Farmaki3Charalampos Agakidis4Kyriaki Papadopoulou-Legbelou51st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece3rd Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece1st Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece1st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece1st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece<b>Background/Objectives:</b> This is the first systematic review and meta-analysis investigating early myocardial dysfunction in children/adolescents with celiac disease and the effect of a gluten-free diet by comparing early echocardiographic markers between patients and healthy individuals and between compliant and non-compliant celiac disease patients (based on serum antibody titers). <b>Methods:</b> A systematic literature search was conducted across major electronic databases, with data collection extending up to 3 March 2024. <b>Results:</b> In total, 15 studies with 916 children/adolescent patients with celiac disease and 569 healthy individuals were included. Our results showed a trend toward reduced myocardial function in all echocardiographic parameters (conventional and advanced), with statistical significance in fractional shortening and the myocardial performance index. However, these parameters did not differ significantly after adherence to a gluten-free diet. <b>Conclusions:</b> Therefore, we recommend that an examination of the cardiovascular system should be incorporated into the routine investigations of children with celiac disease in order to detect early subclinical myocardial dysfunction based on echocardiography. Although the results of our meta-analysis indicate that the myocardial performance index may serve as a useful, non-invasive marker for assessing myocardial function in children and adolescents with celiac disease, further research is needed in order to confirm its reliability and clinical applicability in this population. The improvement of echocardiographic parameters after long-term compliance to a gluten-free diet is yet to be evaluated.https://www.mdpi.com/2227-9067/12/4/441celiac diseasemyocardial dysfunctionchildrensystematic reviewmeta-analysis
spellingShingle Elpida Emmanouilidou-Fotoulaki
Maria Kavga
Michail Delis
Evangelia Farmaki
Charalampos Agakidis
Kyriaki Papadopoulou-Legbelou
Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
Children
celiac disease
myocardial dysfunction
children
systematic review
meta-analysis
title Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
title_full Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
title_fullStr Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
title_full_unstemmed Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
title_short Subclinical Myocardial Dysfunction in Pediatric and Adolescent Celiac Disease Patients: A Systematic Review and Meta-Analysis
title_sort subclinical myocardial dysfunction in pediatric and adolescent celiac disease patients a systematic review and meta analysis
topic celiac disease
myocardial dysfunction
children
systematic review
meta-analysis
url https://www.mdpi.com/2227-9067/12/4/441
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