Cardiac Performance in Patients with Anorexia nervosa

Abstract

The heart function in 15 female patients with anorexia nervosa was examined by means of systolic time intervals. In 3 patients, pulmonary wedge pressure and cardiac output were measured. The findings indicate impaired myocardial contractility in patients with anorexia nervosa.

Effects of Anorexia Nervosa on Clinical, Hematologic, Biochemical, and Bone Density Parameters in Community-Dwelling Adolescent Girls

“…42 Nudel et al 43 found abnormal cardiovascular and sympathetic responses to experimental physical exercise in adolescent girls with AN, and QT prolongation has also been reported in adults with AN. 9,10,19 Decreased myocardial contractility and impaired left ventricular function have been reported in adult women with AN, 11,15 but no differences were found in myocardial contractility in adolescent girls with AN compared with control subjects. 44 However, because cardiovascular events, especially arrhythmias, are a common cause of death in AN, 45 the high prevalence of bradycardia that we found in outpatient adolescent girls who have this eating disorder, although lower than in the 1988 study by Palla and Litt, 19 is disturbing.…”

“…5,7 In addition to these serious complications of AN contributing to the mortality associated with this disorder, other significant changes have been reported in hemodynamic, hematologic, and bone metabolism parameters in adults with AN. [8][9][10][11][12][13][14] Although not life-threatening, these complications can be disabling and contribute to the morbidity of this disorder. Many of these complications result from physiologic adaptation to self-imposed starvation and malnourishment, and a large number are reversible with refeeding, at least in adults.…”

“…15,16 Several groups have examined and reviewed medical complications of AN in adults. [8][9][10][11][12][13][14] However, data derived from adults cannot be extrapolated to adolescents with this disorder, adolescence being a time when critical changes are occurring in the hormonal milieu and in growth, very different from adult life, when pubertal development and growth are complete. The data that are currently available regarding the prevalence of medical complications in adolescent girls who have AN are primarily from hospitalized patients with this disorder 17,18 and from retrospective chart reviews.…”

Cardiac changes in anorexia nervosa

“…Changes in cardiac mass and chamber dimensions present early in anorexia nervosa 15 and have been well studied. Consistently, decreases in left ventricular mass [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and left ventricular end-diastolic and left ventricular end-systolic dimensions 20,23,25,[29][30][31][32][33][34][35] are found; however, some controversy remains regarding some other very specific dimension measures, with some authors finding changes in left ventricular wall thickness [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] or left ventricular posterior wall thickness 2...…”

Heart rate variability as a measure of cardiac autonomic function in anorexia nervosa: A review of the literature

“…For example, patients with anorexia nervosa (AN) are typically bradycardic (resting heart rate (HR) less than 50 per minute) and have relatively low arterial blood pressure (usually lower than 100/50 mm Hg) (Casper, 1986;Kalager, Brubakk, & Bassoe, 1978). Among others, cardiovascular abnormalities reported include QT-interval prolongation (Lesinskiene, Barkus, Ranceva, & Dembinskas, 2008;Takimoto et al, 2004), voltage decrease, T-wave inversion, weight reduction and thinning of the left ventricle, and drop of heart functional parameters (ejection fraction, minute blood volume) (Casiero & Frishman, 2006;Olivares et al, 2005).…”