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青少年起病型神经性厌食症样本的长期心脏评估

Long-term cardiac assessment in a sample of adolescent-onset anorexia nervosa.

作者信息

Flamarique I, Vidal B, Plana M T, Andrés-Perpiñá S, Gárriz M, Sánchez P, Pajuelo C, Mont L, Castro-Fornieles J

机构信息

Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clinic Institute of Neurosciences, Hospital Clínic Universitari de Barcelona, IDIBAPS, CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain.

Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.

出版信息

J Eat Disord. 2022 Jan 31;10(1):12. doi: 10.1186/s40337-022-00533-w.

Abstract

BACKGROUND

High mortality rates have been reported in patients with anorexia nervosa, mainly due to cardiovascular alterations. The purpose of the present study was to assess cardiac structural and functional abnormalities some 20 years after initial treatment in a sample of adolescent-onset anorexia nervosa (A-AN) and to compare them with matched healthy controls (HC).

METHODS

A sample of 29 women diagnosed and treated for AN during adolescence (A-AN) were assessed more than 20 years later. A complete cardiac evaluation was carried out including an electrocardiogram (ECG) and a standard 2D echocardiography. Thirty matched HC were also assessed.

RESULTS

In the A-AN group, four subjects had a body mass index lower than 18.5 and met full DSM 5 criteria for AN at follow-up (Low-Weight group). They were compared with the rest of the sample (n = 25) who had normalized their weight (Normal-Weight group), though some still showed some eating disorder symptoms. Both groups were compared with the HC group. Subjects in the Low-Weight group presented statistically significant decreases in the left ventricular end-diastolic and left atrium dimensions and left ventricular mass in comparison with the Normal-Weight group and the HC. No other differences in cardiac parameters were found between groups.

CONCLUSIONS

Echocardiographic and ECG parameters of adults who had presented A-AN twenty years earlier and currently maintained normal weight were similar to those of HC who had never been treated or diagnosed with AN. Adult subjects with A-AN who still had low weight in the long term present certain cardiac abnormalities similar to those seen in short-lasting disease. More studies are needed to confirm these results in a larger sample.

摘要

背景

神经性厌食症患者的死亡率较高,主要原因是心血管改变。本研究的目的是评估青少年起病的神经性厌食症(A-AN)患者初始治疗约20年后的心脏结构和功能异常,并将其与匹配的健康对照(HC)进行比较。

方法

对29名在青春期被诊断并接受神经性厌食症治疗的女性(A-AN)进行了20多年后的评估。进行了全面的心脏评估,包括心电图(ECG)和标准二维超声心动图。还对30名匹配的HC进行了评估。

结果

在A-AN组中,4名受试者的体重指数低于18.5,在随访时符合DSM 5中神经性厌食症的全部标准(低体重组)。将他们与样本中的其他受试者(n = 25)进行比较,这些受试者的体重已恢复正常(正常体重组),尽管有些人仍表现出一些饮食失调症状。将两组与HC组进行比较。与正常体重组和HC相比,低体重组受试者的左心室舒张末期和左心房尺寸以及左心室质量在统计学上显著降低。各组之间未发现心脏参数的其他差异。

结论

20年前患有A-AN且目前体重维持正常的成年人的超声心动图和心电图参数与从未接受过神经性厌食症治疗或诊断的HC相似。长期体重仍低的成年A-AN受试者存在某些心脏异常,类似于短期疾病中所见的异常。需要更多研究在更大样本中证实这些结果。

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