Electrocardiographic abnormalities in patients with anorexia nervosa.

Thurston, John; Marks, Peta

doi:10.1136/hrt.36.7.719

Cited by 89 publications

(41 citation statements)

References 6 publications

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“…The prolongation of QT interval and QT dispersion might be caused by low nutrition and/or myocardial hypotrophy [14, 15]. However, in the present study, QT interval and QT dispersion were not significantly correlated with BMI in AN patients.…”

Section: Discussioncontrasting

confidence: 54%

QT Interval and QT Dispersion in Eating Disorders

Takimoto

Yoshiuchi

Kumano

et al. 2004

Psychother Psychosom

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Background: Eating disorders are thought to be risk factors for cardiac sudden death secondary to arrhythmia. Results in previous studies on QT interval and QT dispersion, markers of fatal arrhythmia, have been inconsistent. Methods: We prospectively examined 179 female eating disorder patients, being over 18 years old and diagnosed according to the DSM-IV criteria between January 1995 and December 2002, and 52 healthy women. Patients with abnormal plasma electrolytes or taking medications that might influence the electrocardiogram (ECG) were excluded from the study. QT intervals were corrected for heart rate using Bazett’s formula and the nomogram method, which is more reliable at extremely low heart rates than Bazett’s formula. QT dispersion was measured as the difference between the longest and shortest QT intervals. QT intervals and QT dispersion in each patient group were compared with those in the control group. Results: The 164 eligible patients consisted of 43 patients with anorexia nervosa restricting type, 35 with anorexia nervosa binge eating/purging type, 63 with bulimia nervosa purging type, and 23 with bulimia nervosa nonpurging type. There was no significant difference in age between eating disorder patients and controls. QT interval and QT dispersion were significantly longer in all eating disorder subtypes than in the control group. QT interval and QT dispersion were significantly correlated with the rate of body weight loss in bulimia nervosa. Conclusions: QT interval and QT dispersion were prolonged in both anorexia nervosa and bulimia nervosa. Examination of ECG in eating disorder patients without extremely low body weight also appears to be clinically important.

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Section: Discussioncontrasting

confidence: 54%

QT Interval and QT Dispersion in Eating Disorders

Takimoto

Yoshiuchi

Kumano

et al. 2004

Psychother Psychosom

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“…The association of hypokalaemic, hypochloraemic metabolic alkalosis on the basis of self-induced vomiting, purgative or diuretic abuse with anorexia nervosa has been implicated in the genesis of cardiac arrhythmias in the disorder. 7 In extreme cases, hypokalaemia with or without associated dehydration can result in renal failure, I. 8 Other related biochemical changes such as elevations in liver enzymes, hypophosphataemia and hypercholesterolaemia occur in anorexia nervosa" but the true incidence in a clinic population has not been reported.…”

mentioning

confidence: 99%

Biochemical Abnormalities in Anorexia Nervosa and Bulimia

et al. 1987

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SUMMARY.We report the biochemical results in 90 women presenting to an eating disorders clinic: 61 who had bulimia, 22 with anorexia nervosa and seven unclassified. The results were compared with 30 control women. The group of women with an eating disorder had significantly higher concentrations of total CO 2 , calcium, AST, ALT. ALP, albumin and cholesterol and significantly lower concentrations of potassium, chloride and phosphate in the plasma. The elevated calcium could be accounted for in part by an increase in total CO 2 and an increase in albumin. Hypokalaemia was strongly associated with self-induced vomiting and laxative abuse. Biochemical abnormalities occurred in both forms of eating disorders; however. hypercholesterolaemia was more common in anorexia nervosa and abnormal liver enzymes were more common in bulimia.Anorexia ncrvosa and bulimia arc psychosomatic conditions with associated abnormal behaviour related to weight control. 1 The most notable feature of anorexia nervosa is marked weight loss and maintenance of low body weight. 2 Bulimia is characterised by episodes of binge eating 'and severe weight fluctuation.: ': 4 A range of weight-controlling behaviours are used by both anorexia nervosa and bulimia patients, including self-induced vomiting, laxative and diuretic abuse, starvation and dieting. I. 3. 4 The diagnosis is now believed to be more common than previously thought. with an incidence in the Australian young female population of I'Yc, with anorexia nervosa and in the order of 10% with bulimia."There are considerable data available on the biochemical changes associated with anorexia nervosa." These have usually been reported in ill or hospitalised patients who might be expected to have significant metabolic derangement. The association of hypokalaemic, hypochloraemic metabolic alkalosis on the basis of self-induced vomiting, purgative or diuretic abuse with anorexia nervosa has been implicated

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“…However, prolongation of the QT interval may occur in as many as 15 per cent of patients with AN (Cooke et al, 1994;Durakovic, Durakovic, & Korsic, 1994;Palla & Litt, 1988;Thurston & Marks, 1974). QT prolongation is recognized as a risk factor for cardiac arrest, which appears to be a significant cause of death in this disorder (Neumarker, 2000).…”

Section: Discussionmentioning

confidence: 97%

Physical assessment of patients with anorexia nervosa and bulimia nervosa: an international comparison

Kovács

Winston

2003

Euro Eating Disorders Rev

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Objective: A questionnaire study was carried out to determine which investigations were carried out routinely on patients with anorexia nervosa and bulimia nervosa. Method: A specially designed questionnaire was sent to 168 clinicians working in the field of eating disorders in 25 countries. Respondents were asked to supply information about how often they carry out specific investigations on new patients with AN and BN. The questionnaire covered the use of physical examination, biochemical and haematological tests and cardiac investigations. Results: 71 (42.3 per cent) questionnaires were returned. Biochemical investigations and full blood counts were carried out frequently. Significant differences were found between AN patients and BN patients in the measurement of calcium, phosphate and magnesium levels. In some cases, patients with BN were not routinely assessed for hypokalaemia. Micronutrient levels were measured rarely and only 40 per cent of respondents carried out routine electrocardiograms (ECGs) in AN. Discussion: Measurement of serum potassium should be routine in BN and other electrolytes should probably measured more often in both disorders. Detection of treatable micronutrient deficiencies should be given more emphasis and the ECG should become a routine investigation in AN.

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Electrocardiographic abnormalities in patients with anorexia nervosa.

Cited by 89 publications

References 6 publications

QT Interval and QT Dispersion in Eating Disorders

QT Interval and QT Dispersion in Eating Disorders

Biochemical Abnormalities in Anorexia Nervosa and Bulimia

Physical assessment of patients with anorexia nervosa and bulimia nervosa: an international comparison

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