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QT interval and dispersion in drug-free anorexia nervosa adolescents: a case control study

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Abstract

Long QT values have been reported in patients with anorexia nervosa of the restricting type (ANr) potentially increasing the risk of fatal arrhythmia, especially if psychotropic drug treatment is required. Nevertheless, the previous studies on this topic are biased by drug exposure, long disease durations, and small sample sizes. This study is aimed at assessing QTc and QTcd values in ANr adolescents with recent onset and drug free, as compared to subjects affected by psychiatric disorders other than ANr. We evaluated QTc and its dispersion (QTcd) in a population of 77 drug-free ANr female adolescents and compared to an equal number of healthy controls (H-CTRL) and pathological controls (P-CTRL, mixed psychiatric disorders). The QT determination was performed on a standard simultaneous 12-lead ECG in blind by a single experienced investigator. QTc was calculated by the Bazett’s formula and QTcd was determined as the difference between the maximum and minimum QTc intervals in different leads. Only for ANr patients, clinico-demographic data, hormones, and electrolytes were obtained. QTc was slightly reduced in ANr patients (27.7 ms, < 10%, p < 0.0003) vs. controls, while QTcd was increased in P-CTRL (30%, p < 0.0003). Heart rate was significantly lower in ANr patients vs. controls (25%; p < 0.003). Tyroid hormones and serum potassium showed weak although significant positive correlations with QTc in ANr patients. QTcd displayed a weak negative correlation with the BMI percentile (r = − 0.262, p = 0.03). We reject the hypothesis that QTc and QTcd are increased in drug-free ANr adolescents with a relatively short-disease duration. Further studies are needed to understand if the previously reported increase might be related to other associated chronic disorders, such as hormonal or electrolyte imbalance.

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Authors and Affiliations

  1. Child and Adolescent Mental Health, University of Milano-Bicocca, Milan, Italy

    Monica Bomba, Fabiola Corbetta, Francesca Neri & Renata Nacinovich

  2. Neurology, ASST of Monza, University of Milano-Bicocca, Milan, Italy

    Lucio Tremolizzo

  3. School of Medicine and Surgery and Milan-Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy

    Lucio Tremolizzo, Francesca Lanfranconi, Elisa Conti, Francesca Neri & Renata Nacinovich

  4. Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy

    Franco Nicosia

  5. Sport Medicine, “Papa Giovanni XXIII” Hospital, Bergamo, Italy

    Gianni Poggioli

  6. Pediatric Arrhythmias Center, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Karine Goulene & Marco Stramba-Badiale

  7. Child and Adolescent Mental Health Department, “San Gerardo” Hospital, Via Pergolesi 33, 20900, Monza, Italy

    Monica Bomba, Fabiola Corbetta, Francesca Neri & Renata Nacinovich

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  1. Monica Bomba
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Correspondence to Monica Bomba.

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Bomba, M., Tremolizzo, L., Corbetta, F. et al. QT interval and dispersion in drug-free anorexia nervosa adolescents: a case control study. Eur Child Adolesc Psychiatry 27, 861–866 (2018). https://doi.org/10.1007/s00787-017-1080-1

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  • DOI: https://doi.org/10.1007/s00787-017-1080-1

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