Reversibility of cardiac abnormalities in adolescents with anorexia nervosa after weight recovery.
OBJECTIVE
Anorexia nervosa is a life-threatening condition, with significant risk for death due to cardiac complications. The objective of this study was to analyze the cardiac involvement in anorexia nervosa and to study the reversibility of cardiac abnormalities.


METHODS
Thirty-one consecutive adolescents (aged 12 to 17 years) with a diagnosis of anorexia nervosa were evaluated from January 1998 to January 1999 at the Hospital Clínic (University of Barcelona, Catalonia, Spain). An electrocardiogram, an echocardiogram, a 24-hour Holter recording with heart rate variability, an exercise test, and a tilt test were performed at initial examination and after refeeding (3 to 18 months later).


RESULTS
The basal body mass index was 15.2 +/- 2 kg/m2. Sinus bradycardia was found in 35% of patients, 93% showed a decreased left ventricular mass, and 70% had a diminished thickness of cardiac walls. The Holter recordings showed nocturnal bradycardia in 60% with an increased heart rate variability. After refeeding, a significant decrease in QT interval (p <.05) and QT dispersion (p <.01) was observed. Echocardiograms showed an increase in cardiac diameters (p <.01), left ventricular mass (p <.001), and cardiac output (p <.001). There was also an improvement in the exercise capacity (p <.05) and a normalization of the heart rate and heart rate variability (p <.05).


CONCLUSIONS
Cardiac structural and functional abnormalities provoked by anorexia nervosa are reversible in young adolescents after refeeding.
Mont
Lluís
L
Institute of Cardiovascular Diseases, Hospital Clínic, University of Barcelona, Catalonia, Spain. lmont@clinic.ub.es
Castro
Josefina
J
Herreros
Benito
B
Paré
Carles
C
Azqueta
Manel
M
Magriña
Jordi
J
Puig
Josefa
J
Toro
Josep
J
Brugada
Josep
J
D000293:Adolescent; D000856:Anorexia Nervosa / Q000097:blood / Q000453:epidemiology*; D015992:Body Mass Index; D001919:Bradycardia / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004573:Electrolytes / Q000097:blood; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D020127:Recovery of Function; D012720:Severity of Illness Index; D015430:Weight Gain
D004573:Electrolytes