Early repolarization pattern in adult females with eating disorders

Abstract

Introduction The risk of cardiovascular death is increased in patients with eating disorders (ED), but the background for this is unknown. Early repolarization pattern (ERP) on the electrocardiogram (ECG) has been associated with increased risk of sudden cardiac death. Methods We investigated the prevalence of ERP in 233 female patients with anorexia nervosa (AN) and bulimia nervosa (BN) (age 18–35 years) compared with 123 healthy female controls. Results Early repolarization pattern was present in 52 (22%) of ED patients (16 (15%) AN patients and 36 (29%) BN patients) and 17 (14%) of healthy controls. When adjusting for age, BMI, heart rate, use of selective serotonin reuptake inhibitors (SSRI), and potassium level, the odds ratio (OR) for ERP was 2.1 (95% CI 1.1–4.2, p = .03). There was an increased prevalence of inferolateral ERP in patients with ED compared with healthy controls (OR = 4.3, 95% CI 1.7–11.3, p = .003) as well as ERP with a downward/horizontal sloping ST segment (OR = 3.1, 95% CI 1.3–7.6, p = .01). Additionally, J‐point elevation >0.2 mV was more prevalent in patients with ED (OR = 3.3, 95% CI 1.1–9.7, p = .03). Conclusion The prevalence of ERP was increased in patients with ED compared with healthy controls. This finding may provide a possible explanation for the increased cardiovascular mortality in ED patients.

Association between the early repolarization pattern and nocturnal suicide attempts

“…ERP is known to be more common in males 10 and has been reported to be observed in 10% of healthy individuals in East Asia. 11 In the psychiatric field, ERP has been reported to be associated with schizophrenia, 12,13 attention deficit hyperactivity disorder, 14 and eating disorder, 15 but it could be more related to impulsivity, including suicidal intent, rather than to disease specificity. 16 Suicide attempt is a critically important behavioral disorder in mental disorders that is a matter of life and death.…”

Relationship between the early repolarization pattern and a history of suicide attempts among drug‐free psychiatric patients

“…ERP has been shown to be associated with schizophrenia and schizoaffective disorder. 3,4 Similarly, a high prevalence of the ERP has been reported in patients with attention deficit/hyperactivity disorder (ADHD) 5,6 and eating disorders 7 compared with healthy controls. The severity of these disorders can lead to serious psychiatric symptoms such as suicide attempts.…”