title: Relationship between duration of illness and cardiac autonomic nervous activity in anorexia nervosa.
abstract: BACKGROUND
  The mortality rate associated with anorexia nervosa (AN) is high, and death is mainly attributable to cardiac events. A wide range of autonomic nervous system disturbances may be mechanisms underlying the increased cardiovascular mortality and sudden death of patients with AN. Heart rate variability (HRV) has been proven to be a reliable noninvasive method for quantitative assessment of sympathetic and parasympathetic regulation of heart rate (HR). The longer the duration of illness of AN patients, the higher the mortality rate. However, there have been few reports on the relationship between the duration of illness and HRV in AN. Hence, the aims of this study were to compare the cardiac autonomic nervous activity (CANA) of female patients with AN and age-matched female controls and to evaluate the relationship between the duration of illness and the CANA of the AN patients.
  
  
  METHODS
  We studied 14 female patients with AN and 22 age-matched healthy women. Beat-to-beat heart rate variability, recorded in a supine position, was investigated using power spectral analysis.
  
  
  RESULTS
  Mean heart rate was positively correlated with normalized high-frequency (HF: 0.15 to 0.40 Hz) power and negatively correlated with the low-frequency (LF: 0.04 to 0.15 Hz)/HF power (LF/HF) ratio of the controls. On the other hand, duration of illness was negatively correlated with normalized HF power and positively correlated with the LF/HF ratio of the AN patients.
  
  
  CONCLUSIONS
  These results suggest that, given that the LF/HF ratio is an estimate of cardiac sympathovagal balance, anorectic patients with a long illness duration display lower vagal tone (parasympathetic withdrawal) and high sympathetic tone.
authors.affiliation: Kyoto Institute of Health Sciences, Miyako Bldg. 502, Karasuma Oike Agaru Higashigawa, Nakagyo-ku, Kyoto 604-0845 Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Nakai
authors.affiliation: Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Fujita
authors.affiliation: Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nin
authors.affiliation: Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Shun'ichi
authors.initials: S
authors.lastname: Noma
authors.affiliation: Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
keywords: Anorexia nervosa; Cardiac autonomic nervous activity; Heart rate variability; High-frequency power; Low-frequency power