Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

Lachish, M; Stein, Daniel; Kaplan, Zeev; Matar, Michael A.; Faigin, Michal; Korsunski, Isabella; Cohen, Hagit

doi:10.1080/15622970902980770

Cited by 32 publications

(46 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The time and frequency domain analysis in seated subjects showed no significant differences between the control and AN group in agreement with some previous studies [26,24,37]. A decreased low frequency power was found in our study but was not significant in contrast to studies reported by [38,2,22].…”

Section: Hrv Measurescontrasting

confidence: 49%

See 1 more Smart Citation

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Hf¹,

Dj²,

Mp³

et al. 2017

J Metabolic Synd

View full text Add to dashboard Cite

Objective: The objective was to determine changes in heart rate variability (HRV) in response to orthostatic challenge in a convenience sample of patients with anorexia nervosa compared to age-matched controls. A decrease in HRV has been shown to correlate with an increased risk of heart attack in coronary artery disease and heart failure patients. Method:Clinical data and ECG recordings were collected from 37 patients with eating disorders of which 16 had a diagnosis of anorexia nervosa and 42 controls. HRV was analyzed using linear and nonlinear methods during rest and orthostatic challenge from sitting to standing.Results: Significant sympathovagal changes were identified in the anorexia nervosa group, especially with nonlinear HRV parameters and orthostatic challenge. Sample entropy, a nonlinear measure provided the best discrimination between the two groups on standing (1.58 ± 0.42 vs. 1.19 ± 0.4; p<0.0001) and when the change in HRV was measured from sitting to standing (-0.06 ± 0.36 vs. -0.42 ± 0.34; p<0.0001). The anorexia nervosa group had a significantly larger response to orthostatic challenge compared to the control group suggesting sympathetic dysfunction. Discussion: Including nonlinear measures and orthostatic challenge from an ECG recording of anorexia nervosa patients at initial clinical assessment on admission to hospital provides a noninvasive, sensitive tool to determine loss of normal physiological autonomic control of heart rate that may be related to an increased risk of arrhythmic events that requires further monitoring. Conclusion:Nonlinear HRV measures are more sensitive in identifying sympathetic and parasympathetic changes associated with orthostatic challenge in patients with anorexia nervosa.

show abstract

Section: Hrv Measurescontrasting

confidence: 49%

“…However, the studies in AN patients primarily utilized linear methods to evaluate sympathovagal balance. Several of these studies have reported decreased vagal tone whilst others found an increase in parasympathetic activity [21,22,6,[23][24][25]. Other studies report no change or altered sympathovagal balance [26,27].…”

Section: Introductionmentioning

confidence: 95%

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Hf¹,

Dj²,

Mp³

et al. 2017

J Metabolic Synd

View full text Add to dashboard Cite

show abstract

“…Although QT prolongation in AN is largely reversible with appropriate nutrition, 4,5,32,33 overt autonomic dysfunction (and possibly impaired repolarization reserve) may persist for several years despite adequate refeeding and relative normalization of the BMI. 48 Indeed, the highest BMI tertile among patients was of comparable body mass to the control group as a whole; however, despite this, the QT/RR slope was still more gradual in the patients. Therefore, BMI alone may not confidently predict arrhythmic risk, and further studies are required to elaborate on risk factors for arrhythmia in AN, possibly QT/RR slope.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Myocardial Repolarization Reserve in Adolescent Females With Anorexia Nervosa

et al. 2016

View full text Add to dashboard Cite

Background-Patients with anorexia nervosa exhibit abnormal myocardial repolarization and are susceptible to sudden cardiac death. Exercise testing is useful in unmasking QT prolongation in disorders associated with abnormal repolarization. We characterized QT adaptation during exercise in anorexia. Methods and Results-Sixty-one adolescent female patients with anorexia nervosa and 45 age-and sex-matched healthy volunteers performed symptom-limited cycle ergometry during 12-lead ECG monitoring. Changes in the QT interval during exercise were measured, and QT/RR-interval slopes were determined by using mixed-effects regression modeling. Patients had significantly lower body mass index than controls; however, resting heart rates and QT/QTc intervals were similar at baseline. Patients had shorter exercise times (13.7±4.5 versus 20.6±4.5 minutes; P<0.001) and lower peak heart rates (159±20 versus 184±9 beats/min; P<0.001). The mean QTc intervals were longer at peak exercise in patients (442±29 versus 422±19 ms; P<0.001). During submaximal exertion at comparable heart rates (114±6 versus 115±11 beats/min; P=0.54), the QTc interval had prolonged significantly more in patients than controls (37±28 versus 24±25 ms; P<0.016). The RR/QT slope, best described by a curvilinear relationship, was more gradual in patients than in controls (13.4; 95% confidence interval,12.8-13.9 versus 15.8; 95% confidence interval, 15.3-16.4 ms QT change per 10% change in RR interval; P<0.001) and steepest in patients within the highest body mass index tertile versus the lowest (13.9; 95% confidence interval, 12.9-14.9 versus 12.3; 95% confidence interval, 11.3-13.3; P=0.026). Conclusions-Despite

show abstract

“…São utilizados tambémpara melhor compreensão darelação de certas doenças e a modulação autonômica. Em estudo com mulheres diagnosticadas com Anorexia Nervosa, os autores encontraram uma redução da frequência cardíaca, uma baixa VFC, redução no componente LF e elevação no HF sugerindo uma disfunção cardíaca autonômica na forma de anormalidades no controle vagal cardíaco 12 ; Na epilepsia a redução da VFC, durante o período interictal, é caracterizado por diminuição de HF, rMSSD, pNN50 e aumento da relação LF/ HF, refletindo a redução do tônus vagal cardíaco 19,20 .…”

Section: Aplicabilidade Clínica Da Vfcunclassified

Aplicabilidade Clínica da Variabilidade da Frequência Cardíaca

Lopes

Oliveira

André

et al. 2014

RNC

View full text Add to dashboard Cite

Rev Neurocienc 2013;21(4):600-603 revisão 600 RESUMOObjetivo. O objetivo deste trabalho foi revisar aspectos conceituais da Variabilidade da Frequência Cardíaca (VFC), seus dispositivos de mensuração, índices utilizados para sua análise e utilização clínica. Método. Uma revisão de literatura não sistemática realizada através de busca eletrônica conduzidas nas seguintes bases de dados: Medline/ PubMed, Lilacs, Ovid, Science Direct e Biomed Central acerca da utilização clínica da VFC. Resultados. A VFC compreende as oscilações entre os intervalos RR que refletem as modificações na frequência cardíaca em função da atuação conjunta das divisões simpática e parassimpática do sistema nervoso autônomo. Sua análise pode ser executada em função de dois parâmetros: domínio de tempo e domínio de frequência. O eletrocardiograma, conversores analógicos e cardiofrequencímetros são os principais instrumentos utilizados para obtenção de seus índices, onde a alta variabilidade indica boa adaptação fisiológica do organismo, enquanto que sua redução tem sido apontada como importante indicador para o surgimento de patologias ou de complicações em pacientes com doenças de base conhecidas. Conclusâo. O estudo da VFCvem se apresentando como importante ferramenta de avaliação do funcionamento do organismo em condições normais e patológicas proporcionando assim o desenvolvimento de ações pelos profissionais da saúde visando prevenção e/ou detecção de várias fisiopatologias.Unitermos. Frequência Cardíaca, Adaptação Fisiológica, Sistema Nervoso Autônomo.Citação. Lopes PFF, Oliveira MIB, Sousa AndréSM, Nascimento DLA, Silva CSS, Rebouças GM, Renee Felipe T, Albuquerque Filho NJB, Medeiros HJ. Aplicabilidade Clínica da Variabilidade da Frequência Cardíaca. ABSTRACTObjective. The purpose of this study was to review the conceptual aspects of Heart Rate Variability (HRV), its measurement devices, indexes used for analysis and clinical use. Method. A non-systematic literature review conducted through electronic search conducted in the following databases: Medline/PubMed, Lilacs, Ovid, Science Direct and BioMed Central about the clinical use of HRV. Results. HRV comprises oscillations between RR intervals that reflect the changes in heart rate due to the joint action of the sympathetic and parasympathetic divisions of the autonomic nervous system. The HRV's analysis can be performed by the basis of two parameters: the time domain and frequency domain. The electrocardiogram, heart monitors and analog converters are the main instruments used to obtain indices that allow the assessment of HRV, whose high variability indicates good physiological adaptation of the organism while its reduction has been identified as an important indicator for the emergence of pathologies or complications in patients with underlying diseases known. Conclusion. The study of HRV has been presented as an important tool for assessing the body functioning in normal and pathological conditions thus providing the development of actions by health professionals aiming preventio...

show abstract

Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

Cited by 32 publications

References 50 publications

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa

Characterization of Myocardial Repolarization Reserve in Adolescent Females With Anorexia Nervosa

Aplicabilidade Clínica da Variabilidade da Frequência Cardíaca

Contact Info

Product

Resources

About