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Cardiac findings in adolescents with anorexia nervosa at diagnosis and after weight restoration

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Abstract

The aim of this study was to compare heart abnormalities in a group of young women with anorexia nervosa at diagnosis and after weight restoration. A total of 40 young women with anorexia nervosa were evaluated, at baseline, (diagnosis) and follow-up (9 to 18 months later) and matched with 40 healthy women of the same age and of normal weight. QT interval was measured from surface electrocardiograms. QT dispersion was defined as the difference between maximum QT and minimum QT occurring in any of the 12 leads. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass, left ventricular mass index, cardiac output, fractional shortening and fractional ejection, were measured by echocardiography. In anorexia nervosa patients, corrected QT interval and QT dispersion, significantly decreased from baseline to follow-up. Left ventricular end-diastolic dimension, left ventricular mass index, and cardiac output, in anorexia nervosa were significantly lower at diagnosis than at follow-up after weight restoration. Conclusion:Adolescents with anorexia nervosa have significant functional and structural cardiac abnormalities; weight gain was associated with improvement. Appropriate attention should be paid to cardiac involvement.

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Abbreviations

LVm :

left ventricular mass

QTc :

corrected QT

QTd :

QT dispersion

References

  1. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington

  2. Bazett HC (1920) An analysis of the time relations of electrocardiograms. Heart 7: 353–370

    Google Scholar 

  3. Clark AF, Wildenthal K (1986) Disproportionate reduction of actin synthesis in hearts of starved rats. J Biol Chem 261: 13168–13172

    Google Scholar 

  4. Conri C, Roudaut R, Ducloux G, Fleury B, Moreu F (1989) Étude échocardiographique au cours de l’anorexie mentale. Press Méd 18: 806–808

    Google Scholar 

  5. Cooke RA, Chambers JB, Singh R, Todd GJ, Smeeton NC, Treasure J, Treasure T (1994) QT interval in anorexia nervosa. Br Heart J 72: 69–73

    Google Scholar 

  6. De Filippo E, Signorini A, Bracale R, Pasanisi F, Contaldo F (2000) Hospital admission and mortality rates in anorexia nervosa: experience from an integrated medical-psychiatric outpatient treatment. Eat Weight Disord 5: 211–216

    Google Scholar 

  7. De Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, De Divitiis O (1992) Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and of the impact of overweight. J Am Coll Cardiol 20: 1251–1260

    Google Scholar 

  8. Devereux RB, Reichek N, Meyer RA (1977) Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 55: 613–618

    Google Scholar 

  9. Galetta F, Franzoni F, Cupisti A, Belliti D, Prattichizzo F, Rolla M (2002) QT interval dispersion in young women with anorexia nervosa. J Pediatr 140: 456–460

    Google Scholar 

  10. Girola A, Enrini R, Garbetta F, Tufano A, Caviezel F (2001) QT dispersion in uncomplicated human obesity. Obes Res 9: 71–77

    Google Scholar 

  11. Higham PD, Campbell RW (1994) QT dispersion. Br Heart J 71: 508–510

    Google Scholar 

  12. Hill JA, Friedman PL (1997) Measurement of QT interval and QT dispersion. Lancet 349: 894–895

    Google Scholar 

  13. Lombardi F (1998) The QT interval and QT dispersion: the smaller, the better! Eur Heart J 19: 1279–1281

    Google Scholar 

  14. Lund K, Perkiomaki JS, Brohet C, Elming H, Zaidi M, Torp C, Huikuri HV, Nygaard H, Kirstein A (2002) The prognostic accuracy of different QT interval measures. Ann Noninvasive Electrocardiol 7: 10–16

    Google Scholar 

  15. Mayet J, Shashi M, McGrath K, Poulter NR, Sever PS, Foale RA, Thom SA (1996) Left ventricular hypertrophy and QT dispersion in hypertension. Hypertension 28: 791–796

    Google Scholar 

  16. Mont L, Castro J, Herreros B, Paré C, Azqueda M, Magriña J, Puig J, Toro J, Brugada J (2003) Reversibility of cardiac abnormalities in adolescents with anorexia nervosa alter weight recovery. J Am Acad Child Adolesc Psychiatry 42: 808–813

    Google Scholar 

  17. Neumaker KJ (1997) Mortality and sudden death in anorexia nervosa. Int J Eat Disord 21: 205–212

    Article  Google Scholar 

  18. Nudel DB, Gootman N, Nussbaum MP, Shenker IR (1984) Altered exercise performance and abnormal sympathetic responses to exercise in patients with anorexia nervosa. J Pediatr 105: 34–37

    Google Scholar 

  19. Palma JL, Arribas A, González JR, Martín E, Simarro E (2000) Guías de práctica clínica de la Sociedad Española de Cardiología en la monitorización ambulatoria del electrocardiograma y presión arterial. Rev Esp Cardiol 53: 91–109

    Google Scholar 

  20. Panagiotopoulos C, McCrindle BW, Hick K, Katzman K (2000) Electrocardiographic findings in adolescents with eating disorders. Pediatrics 105: 1100–1105

    Google Scholar 

  21. Powers PS, Schocken DD, Feld J, Holloway JD, Boyd F (1991) Cardiac function during weight restoration in anorexia nervosa. Int J Eat Disord 10: 521–530

    Google Scholar 

  22. Romano C, Chinalli M, Pasanisi F, Greco R, Celentano A, Rocco A, Palmieri V, Signorini A, Contaldo F, Simone G (2003) Reduced hemodynamic load and cardiac hypotrophy in patients with anorexia nervosa. Am J Clin Nutr 77: 308–312

    Google Scholar 

  23. Rossi MA, Zucoloto S (1982) Ultrastructural changes in nutritional cardiomyopathy of protein-calorie malnourished rats. Br J Exp Pathol 63: 2242–253

    Google Scholar 

  24. Sahn DJ, DeMaria A, Kisslo J, Weyman A (1978) The committee on M-mode standardization of the American Society of Echocardiography. Results of a survey of echocardiographic measurements. Circulation 58: 1072–1083

    CAS  PubMed  Google Scholar 

  25. St John Sutton MG, Plapper T, Crosby L, Douglas P, Mullen J, Reichek N (1985) Effects of reduced left ventricular mass on chamber architecture, load and function: a study of anorexia nervosa. Circulation 72: 991–1000

    Google Scholar 

  26. Swenne I, Larsson PT (1999) Heart risk associated with weight loss in anorexia nervosa and eating disorders: risk factors for QTc interval prolongation and dispersion. Acta Paediatr 88: 304–309

    Google Scholar 

  27. Tolnai S, von Althen I (1987) Calcium-dependent proteolysis in the myocardium of rats subjected to stress. Life Sci 41: 1117–1122

    Google Scholar 

  28. Vázquez M, Olivares JL, Fleta, J, Lacambra I, González M (2003) Cardiac disorders in young women with anorexia nervosa. Rev Esp Cardiol 56: 669–673

    Google Scholar 

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Correspondence to José L. Olivares.

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Olivares, J.L., Vázquez, M., Fleta, J. et al. Cardiac findings in adolescents with anorexia nervosa at diagnosis and after weight restoration. Eur J Pediatr 164, 383–386 (2005). https://doi.org/10.1007/s00431-005-1647-6

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  • DOI: https://doi.org/10.1007/s00431-005-1647-6

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