Heart rate variability as a measure of autonomic nervous system function in anorexia nervosa

Abstract

Background and hypothesis: Alteration in sympathovagal balance may be a mechanism of increased cardiovascular mortality and sudden death of patients with anorexia nervosa. This study was undertaken to characterize cardiac autonomic control in patients with anorexia nervosa by means of heart rate variability analysis. Methods: Heart period variability by 24‐h Holter recording was evaluated in 13 young women with anorexia nervosa, 10 constitutionally thin women, and 10 women of normal weight. Results: High‐frequency power, a measure of parasympathetic modulation of heart rate, and all‐time domain measures of heart rate variability were higher in patients with anorexia nervosa than in thin women and in those of normal weight. Thin women showed lower values of total power and of most components of power spectrum. Conclusions: Our data demonstrate an increased vagal tone in young women with anorexia nervosa. The marked increase in parasympathetic activity, not in response to an increase in sympathetic activity, could be detrimental and may contribute to the higher cardiovascular mortality of these patients.

A 6-weeks Treatment Program Improves HRV in Eating Disorder Patients

“…The present finding is consistent with previous results that eating disorder patients have symptoms of vagal hyperactivity [23][24][25][26]. This sympathovagal imbalance may contribute in part to cardiac autonomic dysfunction.…”

“…Moreover, repolarisation abnormalities and prolongation of ECG Q-T interval are thought to be associated with ventricular arrhythmia and severe weight loss [26,32]. However, a number of studies of HRV have confirmed that these structural and functional abnormalities of the cardiovascular system provoked by AN are reversible after weight restoration [9,25,28,29,33]. This study indicated that HRV in ED patients is lower than control, especially HRV complexity measured by Sample Entropy.…”

Medical complications in adolescents with anorexia nervosa: A review of the literature

“…11,12 Electrocardiographic abnormalities are present in most adolescents with AN. 3,4,6,7 Sinus bradycardia is reported to be present in 35-95% of adolescents with AN, 1,[3][4][5] and is believed to be due to the reported increased vagal tone 4,9,10 and decreased metabolic rate.…”

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

“…However, the studies in AN patients primarily utilized linear methods to evaluate sympathovagal balance. Several of these studies have reported decreased vagal tone whilst others found an increase in parasympathetic activity [21,22,6,[23][24][25]. Other studies report no change or altered sympathovagal balance [26,27].…”