title: Echocardiographic findings in adolescents with anorexia nervosa at beginning of treatment and after weight recovery.
abstract: Anorexia nervosa (AN) is an eating disorder with somatic complications. The aim of the study was to analyse echocardiographic abnormalities in patients with AN at initial examination and after weight restoration. A total of 173 consecutively admitted adolescents (aged 12-17 years), diagnosed with DSM-IV AN (307.1) were evaluated in a child and adolescent psychiatric department of a major university hospital from December 1997 to August 2008. In addition, 40 healthy adolescents of the same age with normal weight were examined. In patients with AN, 34.7% had a pericardial effusion (PE) which was clinically silent. In contrast, none of the controls presented with PE (p < 0.001). No differences across AN subtypes were observed. Patients with PE showed significantly lower body mass index (BMI) (p = 0.016) than patients without PE. They had more prominent low-T3 syndrome (p = 0.003) and longer duration of hospitalisation (p = 0.008) after controlling for BMI at admission. Remission of PE was observed in 88% of the patients after weight restoration. Left ventricular end-diastolic and end-systolic dimensions in AN were significantly lower than in controls (p < 0.001). There were no differences in interventricular septum thickness, posterior wall thickness and fractional shortening. This report indicates that adolescents with AN show cardiac abnormalities in comparison to healthy young women. Furthermore, PE is a frequent cardiac complication in patients with AN and it is associated with BMI, low T3 serum levels and duration of hospitalisation.
authors.affiliation: Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Germany. sabrina.kastner@gmx.de
authors.forename: Sabrina
authors.initials: S
authors.lastname: Kastner
authors.forename: Harriet
authors.initials: H
authors.lastname: Salbach-Andrae
authors.forename: Babette
authors.initials: B
authors.lastname: Renneberg
authors.forename: Ernst
authors.initials: E
authors.lastname: Pfeiffer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lehmkuhl
authors.forename: Lothar
authors.initials: L
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000145:classification / Q000150:complications* / Q000178:diet therapy*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002648:Child; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D010490:Pericardial Effusion / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology
references.citation: J Adolesc Health Care. 1983 Mar;4(1):9-14
references.pmid: 6841243
references.citation: Arch Mal Coeur Vaiss. 2001 May;94(5):494-8
references.pmid: 11434018
references.citation: J Pediatr. 2002 Apr;140(4):456-60
references.pmid: 12006961
references.citation: Prax Kinderpsychol Kinderpsychiatr. 1995 May-Jun;44(5):158-67
references.pmid: 7675750
references.citation: Curr Opin Psychiatry. 2006 Jul;19(4):438-43
references.pmid: 16721178
references.citation: Circulation. 1985 Nov;72(5):991-1000
references.pmid: 4042307
references.citation: Echocardiography. 2008 Mar;25(3):321-7
references.pmid: 18307446
references.citation: Circulation. 1978 Sep;58(3 Pt 1):425-33
references.pmid: 679432
references.citation: Br Heart J. 1994 Mar;71(3):287-92
references.pmid: 8142200
references.citation: Rev Esp Cardiol. 2003 Jul;56(7):669-73
references.pmid: 12855149
references.citation: Arch Dis Child. 2008 Dec;93(12):1033-6
references.pmid: 18499774
references.citation: Int J Eat Disord. 2005;37 Suppl:S52-9; discussion S87-9
references.pmid: 15852321
references.citation: Int J Cardiol. 2006 Jan 13;106(2):170-6
references.pmid: 16321688
references.citation: Int J Eat Disord. 2006 Nov;39(7):609-11
references.pmid: 16937387
references.citation: Eur Child Adolesc Psychiatry. 2001 Mar;10(1):54-7
references.pmid: 11315536
references.citation: J Adolesc Health Care. 1988 Jan;9(1):15-21
references.pmid: 3335466
references.citation: Psychosom Med. 1987 May-Jun;49(3):285-90
references.pmid: 3602298
references.citation: J Adolesc Health. 2003 Jun;32(6):416-21
references.pmid: 12782452
references.citation: Pediatrics. 1988 May;81(5):613-23
references.pmid: 3162764
references.citation: J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
references.pmid: 16376782
references.citation: Eur Heart J. 2004 Apr;25(7):587-610
references.pmid: 15120056
references.citation: Int J Eat Disord. 2003 Apr;33(3):364-6
references.pmid: 12655635
references.citation: Ann Intern Med. 1986 Sep;105(3):384-6
references.pmid: 3740676
references.citation: Pediatr Cardiol. 1983 Apr-Jun;4(2):125-7
references.pmid: 6878068
references.citation: Br J Psychiatry. 1993 Apr;162:452-62
references.pmid: 8481735
references.citation: J Am Acad Child Adolesc Psychiatry. 2003 Jul;42(7):808-13
references.pmid: 12819440
references.citation: Eat Weight Disord. 2003 Mar;8(1):68-71
references.pmid: 12762627
references.citation: Cardiol Rev. 2006 Sep-Oct;14(5):227-31
references.pmid: 16924163
references.citation: J Adolesc Health. 2003 Dec;33(6):418-26
references.pmid: 14642704
references.citation: Pediatrics. 2000 May;105(5):1100-5
references.pmid: 10790469
references.citation: J Am Soc Echocardiogr. 2004 Oct;17(10):1086-119
references.pmid: 15452478
references.citation: Eur J Pediatr. 2005 Jun;164(6):383-6
references.pmid: 15909184
references.citation: G Ital Cardiol. 1998 Feb;28(2):131-9
references.pmid: 9534053