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Long-Term Prognosis in Anorexia Nervosa

Long-Term Prognosis in Anorexia Nervosa. The cardiovascular implications during refeeding and after weight recovery. Mary Carter. Anorexia Nervosa (AN). Is a life-threatening illness which can be accompanied by cardiac symptoms of varying severity.

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Long-Term Prognosis in Anorexia Nervosa

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  1. Long-Term Prognosis in Anorexia Nervosa The cardiovascular implications during refeeding and after weight recovery Mary Carter

  2. Anorexia Nervosa (AN) • Is a life-threatening illness which can be accompanied by cardiac symptoms of varying severity. • Eighty percent of patients with an eating disorder are effected by a cardiac complication. • It has been reported that approximately one third of deaths are due to cardiac complications.

  3. Some cardiac complications • Sinus Bradycardia • Hypotension • Increased Vagal Tone • Decreased Voltage and QT Interval Prolongation • Diminished Wall Thickness • Reduced Cardiac Output

  4. During Refeeding • Experimental evidence in animals suggests that decreased compliance and diminished systolic contractility persists. • Myofibrillar destruction and edema observed in clinical and experimental starvation offers one explanation for decreased ventricular compliance.

  5. Refeeding Syndrome • Accounts for the cardiovascular decompensation seen during therapy. • It is a known complication of parenteral hyperalimentation. • Hyperalimentation produces striking hypophosphatemia. • Phosphate depletion produces wide-spread abnormalities at the cellular level.

  6. Weight Recovery • Patients showed a significant decrease in QT interval (p<.05), and QT dispersion (p<.01) • Electrocardiograms showed an increase in cardiac diameters (p<.01), left ventricular mass (p<.001), and cardiac output (p<.001). • Exercise capacity improved (0<.05) • And there was a normalization of heart rate and heart rate variability (p<.05).

  7. References • Mont, Louis, et al, “Reversibility of Cardiac Abnormalities in Adolescents With Anorexia Nervosa After Weight Recovery, Journal of American Academy of Child Psychiatry, 42:7, July, 2003. • Schochen, Douglas, et al, “Weight Loss and the Heart: Effects of AN and Starvation”, Archives of Internal Medicine, Vol. 149, April 1989.

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