Lesinskiene Sigita, Barkus Arunas, Ranceva Nadezda, Dembinskas Algirdas
Psychiatry Clinic, Vilnius University, Vilnius, Lithuania.
World J Biol Psychiatry. 2008;9(2):86-91. doi: 10.1080/15622970701230963.
Reports have suggested association between sudden death and QT prolongation in AN patients. Incidence and clinical consequences of cardiac abnormalities remain controversial. As the course of AN disease is long-lasting it remains unclear how often psychiatrists should send AN patients for somatic and especially cardiological investigation. The objective of the study was to aggregate the published data on HR and QT alteration and to perform a meta-analysis of the HR and QT alteration in patients with anorexia nervosa.
A Medline search of all English language studies from 1994 to 2005 was performed. The inclusion criteria were confirmed diagnosis of AN, measurement of QTc and mean heart rate. Data from 10 studies were analyzed using weighted linear regression model.
Analysis showed that bradycardia and relationship between HR and BMI decreases as the disease continues. QTc interval in AN patients was within normal range although significantly longer than in controls.
Further investigations of sudden death in patients with AN due to cardiac arrest are needed and a model of clinical monitoring of cardiovascular system should be elaborated. If QTc prolongation is detected even in the normal range further cardiological examination for risk assessment and systematic clinical surveillance of the cardiovascular system should be considered.
有报告指出神经性厌食（AN）患者猝死与QT间期延长之间存在关联。心脏异常的发生率及临床后果仍存在争议。由于AN病程持久，目前尚不清楚精神科医生应多频繁地将AN患者送去进行躯体检查，尤其是心脏检查。本研究的目的是汇总已发表的关于心率（HR）和QT改变的数据，并对神经性厌食症患者的HR和QT改变进行荟萃分析。
对1994年至2005年所有英文研究进行了Medline检索。纳入标准为确诊为AN、测量QTc和平均心率。使用加权线性回归模型分析了10项研究的数据。
分析表明，随着病情发展，心动过缓以及HR与体重指数（BMI）之间的关系降低。AN患者的QTc间期在正常范围内，尽管明显长于对照组。
需要对因心脏骤停导致的AN患者猝死进行进一步研究，并应制定心血管系统临床监测模型。即使在正常范围内检测到QTc延长，也应考虑进一步进行心脏检查以评估风险，并对心血管系统进行系统的临床监测。
