Linear and non‐linear heart rate variability measures in chronic and acute phase of anorexia nervosa

Platiša, M.; Nestorovic, Zorica; Damjanović, Svetozar; Gal, Vera

doi:10.1111/j.1475-097x.2005.00653.x

Cited by 25 publications

(26 citation statements)

References 44 publications

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“…However, the evidence from these data is poor as they were collected in 6 patients only. Similar data were obtained by Platisa, Nestorovic, Damjanovic and Gal (2006). Results of this study also point to decreased sympathetic modulation in chronic AN and an increased parasympathetic modulation in acute AN.…”

Section: Studies Using 24-hour Recordingsupporting

confidence: 90%

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

Mazurak

Enck

Muth

et al. 2010

Euro Eating Disorders Rev

102

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Twenty papers on HRV in patients with anorexia were identified and analysed, revealing three distinct positions regarding changes of autonomic nervous system (ANS) functions in patients with AN. The majority of papers identified parasympathetic/sympathetic imbalance with parasympathetic dominance and decreased sympathetic modulation; others could not replicate these findings, but instead described sympathetic dominance; finally a group of papers could not identify any autonomic differences in comparison to control samples. We conclude that in its current state of analysis HRV may not be suitable for routine assessment of ANS function in AN patients but rather remains a research tool.

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Section: Studies Using 24-hour Recordingsupporting

confidence: 90%

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

Mazurak

Enck

Muth

et al. 2010

Euro Eating Disorders Rev

102

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show abstract

“…Studies on the changes in HRV following orthostatic challenge in AN patients have not produced consistent findings [27,2,36,28,32]. The time and frequency domain analysis in seated subjects showed no significant differences between the control and AN group in agreement with some previous studies [26,24,37].…”

Section: Hrv Measuressupporting

confidence: 76%

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Hf¹,

Dj²,

Mp³

et al. 2017

J Metabolic Synd

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Objective: The objective was to determine changes in heart rate variability (HRV) in response to orthostatic challenge in a convenience sample of patients with anorexia nervosa compared to age-matched controls. A decrease in HRV has been shown to correlate with an increased risk of heart attack in coronary artery disease and heart failure patients. Method:Clinical data and ECG recordings were collected from 37 patients with eating disorders of which 16 had a diagnosis of anorexia nervosa and 42 controls. HRV was analyzed using linear and nonlinear methods during rest and orthostatic challenge from sitting to standing.Results: Significant sympathovagal changes were identified in the anorexia nervosa group, especially with nonlinear HRV parameters and orthostatic challenge. Sample entropy, a nonlinear measure provided the best discrimination between the two groups on standing (1.58 ± 0.42 vs. 1.19 ± 0.4; p<0.0001) and when the change in HRV was measured from sitting to standing (-0.06 ± 0.36 vs. -0.42 ± 0.34; p<0.0001). The anorexia nervosa group had a significantly larger response to orthostatic challenge compared to the control group suggesting sympathetic dysfunction. Discussion: Including nonlinear measures and orthostatic challenge from an ECG recording of anorexia nervosa patients at initial clinical assessment on admission to hospital provides a noninvasive, sensitive tool to determine loss of normal physiological autonomic control of heart rate that may be related to an increased risk of arrhythmic events that requires further monitoring. Conclusion:Nonlinear HRV measures are more sensitive in identifying sympathetic and parasympathetic changes associated with orthostatic challenge in patients with anorexia nervosa.

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“…Platisa et al (2006) evaluated linear and non-linear measures of HRV, and found differences in both measures in acute and chronic AN patients over a 24-h assessment period. Specifically, acute AN was characterized by decreased HR and increased HRV, whereas chronic AN patients showed increased HR, reduced HRV and higher differences between awakening and sleeping conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, almost 80% of AN patients have cardiovascular abnormalities, mainly bradycardia, hypotension, arrhythmias and repolarization disorders. Additionally, AN patients may present with reduced left ventricular mass (Galetta et al 2003;Romano et al 2003) and alterations in sympathovagal balance (Kollai et al 1994;Kreipe et al 1994;Petretta et al 1997;Rechlin et al 1998;Casu et al 2002;Galetta et al 2003;Cong et al 2004;Melanson et al 2004;Platisa et al 2005;Platisa et al 2006), the latter being of parrticular relevance in increasing the risk of cardiovascular mortality and sudden death in AN (Neumarker 1997).…”

Section: Introductionmentioning

confidence: 98%

Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

Lachish

Stein

Kaplan

et al. 2009

The World Journal of Biological Psychiatry

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Anorexia nervosa (AN) patients may present with cardiac autonomic system dysfunction. Power spectral analysis of heart rate variability (HRV) is a reliable noninvasive examination for the quantitative assessment of the central sympathovagal interaction that modulates cardiovascular autonomic function. In the present study, HRV parameters were assessed in female adolescent AN inpatients in the malnourished phase at admission, at discharge when achieving weight restoration, and 24-36 months after discharge, when considered remitted. Nineteen normal-weight female controls were similarly assessed. Spectral analysis of HRV was done with the fast Fourier transform algorithm. At admission and discharge, patients underwent routine laboratory examinations and responded to questionnaires assessing eating-related preoccupations, behaviors, and personality attributes, depression and anxiety. Compared with the controls, AN patients had significantly lower heart-rate and HRV, lower total power and low frequency components, elevated high frequency components, and decreased low to high frequency power ratio as assessed with the power spectral analysis at all three evaluation points. These disturbances were not correlated with the baseline laboratory and psychometric measures. Our preliminary findings suggest that female adolescent AN inpatients may have a cardiovascular autonomic dysfunction in the form of vagal abnormality present not only in malnourished patients, but also persisting following short-term and long-term weight restoration.

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Linear and non‐linear heart rate variability measures in chronic and acute phase of anorexia nervosa

Cited by 25 publications

References 44 publications

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

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

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

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