QT interval and dispersion in drug-free anorexia nervosa adolescents: a case control study
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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.
KeywordsQTc QTcd Anorexia nervosa Drug-free Adolescence
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Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Krantz MJ, Sabel AL, Sagar U, Long CS, Barbey JT, White KV, Gaudiani JL, Mehler PS (2012) Factors influencing QT prolongation in patients hospitalized with severe anorexia nervosa. Gen Hosp Psychiatry 34:173–177. https://doi.org/10.1016/j.genhosppsych.2011.08.003 CrossRefPubMedGoogle Scholar
- 9.Carrà G, Crocamo C, Bartoli F, Lax A, Tremolada M, Lucii C, Martinotti G, Nosè M, Bighelli I, Ostuzzi G, Castellazzi M, Clerici M, Barbui C, STAR Network Group (2016) First-generation antipsychotics and QTc: any role for mediating variables? Hum Psychopharmacol 31(4):313–318. https://doi.org/10.1002/hup.2540 CrossRefPubMedGoogle Scholar
- 15.Nahshoni E, Weizman A, Yaroslavsky A, Toledano A, Sulkes J, Stein D (2007) Alterations in QT dispersion in the surface electrocardiogram of female adolescents diagnosed with restricting-type anorexia nervosa. J Psychosom Res 62(4):469–472. https://doi.org/10.1016/j.jpsychores.2006.10.023 CrossRefPubMedGoogle Scholar
- 16.Nussinovitch M, Gur E, Kaminer K, Volovitz B, Nussinovitch N, Nussinovitch U (2012) QT variability among weight-restored patients with anorexia nervosa. Gen Hosp Psychiatry 34:62–65. https://doi.org/10.1016/j.genhosppsych.2011.06.012 CrossRefPubMedGoogle Scholar
- 17.Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports Medicine (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43:1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb CrossRefPubMedGoogle Scholar
- 18.Tremolizzo L, Conti E, Bomba M, Uccellini O, Rossi MS, Marfone M, Corbetta F, Santarone ME, Raggi ME, Neri F, Ferrarese C, Nacinovich R (2014) Decreased whole-blood global DNA methylation is related to serum hormones in anorexia nervosa adolescents. World J Biol Psychiatry 15:327–333. https://doi.org/10.3109/15622975.2013.860467 CrossRefPubMedGoogle Scholar
- 21.Padfield GJ, Escudero CA, DeSouza AM, Steinberg C, Gibbs K, Puyat JH, Lam PY, Sanatani S, Sherwin E, Potts JE, Sandor G, Krahn AD (2016) Characterization of myocardial repolarization reserve in adolescent females with anorexia nervosa. Circulation 133:557–565. https://doi.org/10.1161/CIRCULATIONAHA.115.016697 PubMedCrossRefGoogle Scholar