Cardiovascular Injury in Anorexia Nervosa

Abstract

Objective. Demonstrating cardiovascular injury amoung a group of female patients suffering from anorexia, compared to a similarly-aged group of women with body mass within the normal range. Materials and methods. Clinical, biological and paraclinical parameters were determined in the two patient groups: Group A, consisting of 39 patients suffering from anorexia, and Group B, consisting of 40 patients of similar ages, but having a normal body-mass index (BMI). Results. Compared to the normal-BMI cohort, the female patients diagnosed with anorexia are more bradycardic, have lower blood pressure, biologically were found to suffer from various degrees of anemia (hypochromic, microcytic, caused by iron deficiency), leucocytosis, thrombocytosis, hypoglicemia, slight nitrogen compounds retention, hyponatremia, hypokalemia, hypochloremia, hypomagnesemia, hypocalcemia, hypophosphatemia, low levels of triglycerides and of all cholesterol fractions, hypoproteinemia with hypoalbuminemia, mild hepatic cytolysis, increased levels of creatine kinase and cortisol. In terms of echocardiographic findings, the patients with anorexia have decreased dimensions of all cardiac chambers and of the inferior vena cava, lower cardiac output and index, diminished A-wave velocity, with an increase in E/A ratio, lower E', A' and S' velocities for the lateral ventricular wall, along with lower E' and A' velocities for the interventricular septum, and a decrease in both tricuspid annular and mitral annular systolic excursions. Discussions. There is an obvious link between the magnitude of clinical, biological and paraclinical abnormalities and low BMI. Further studies are needed in order to establish the degree of reversibility of said abnormalities following the total or partial correction of the patients' nutritional deficit. Conclusions. The patients suffering from anorexia present with multiple abnormal findings, both biological and clinical in nature, alongside a subclinical negative impact on the cardiovascular system. Early detection of these negative changes could impose the adoption of a realimentation plan, possibly accompanied by the use of specific pharmacological agents, that would bring about improvements in these patients' overall status.