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Cardiac abnormalities determined by tissue Doppler imaging and arrhythmias in adolescents with anorexia nervosa

Part of: Cardiac Morphology Echocardiography Electrophysiology

Published online by Cambridge University Press:  07 June 2021

Vicente Nehgme Open the ORCID record for Vicente Nehgme [Opens in a new window] ,
Patricia Rios ,
Valeria Acevedo  and
Patricia Alvarez
Vicente Nehgme*
Affiliation:
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, NY, USA
Patricia Rios
Affiliation:
Department of Diagnostic Imaging, Universidad del Desarrollo, Facultad de Medicina Clinica Alemana, Las Condes, Chile
Valeria Acevedo
Affiliation:
Department of Pediatric Cardiology, Hospital de Niños Roberto del Rio, Santiago, Chile Clinica Alemana de Santiago, Vitacura, Chile Universidad de Chile, Facultad de Medicina, Santiago, Chile
Patricia Alvarez
Affiliation:
Department of Pediatric Cardiology, Hospital de Niños Roberto del Rio, Santiago, Chile Clinica Alemana de Santiago, Vitacura, Chile Universidad de Chile, Facultad de Medicina, Santiago, Chile
*
Author for correspondence: Dr V. Nehgme, MPH, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, NY11549, USA. E-mail: vicente.nehgme@gmail.com
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Abstract

Background:

Anorexia nervosa has a prevalence of 0.5–3% in adolescents, placing this population at increased risk of cardiac anomalies including arrhythmias, pericardial effusion, and myocardial dysfunction. Our objective is to describe cardiovascular anomalies observed by tissue Doppler imaging in patients with anorexia nervosa.

Methods:

We retrospectively reviewed electrocardiogram, Holter, and echocardiography findings in 28 patients diagnosed with anorexia nervosa.

Results:

Electrocardiogram was abnormal in 71% of patients with sinus bradycardia observed in 57%. Holter confirmed sinus bradycardia without significant pauses. Prolonged QTc, low voltage, and ectopic beats were each seen in 14% of patients. Wenckebach atrioventricular block was observed in one patient. Supraventricular or ventricular tachycardia was not observed. Echocardiography showed structurally normal heart in all patients. Pericardial effusion was seen in 7.1% of patients and left ventricular mass was decreased in 10.7%. Mean ejection fraction was 0.73 and mean fractional shortening was 38.4%. Tissue Doppler imaging revealed systolic or diastolic dysfunction in four patients with e’, a’, and s’ velocities in the lateral and septal basal segments more than two standard deviations below the mean. Two patients had decreased left ventricular mass but no significant difference in disease duration from the group. Basal segment velocities below one standard deviation were also observed in an additional seven patients.

Conclusion:

A trend for decreased tissue Doppler imaging velocities was seen in 25.0% of patients, while significant systolic and diastolic dysfunction was seen in 14.3% of patients, associated with a significant reduction in left ventricular mass and independent of disease duration.

Keywords

EchocardiographyDoppleranorexia
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 2 , February 2022 , pp. 266 - 269
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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