Is QTc-Interval Prolongation an Inherent Feature of Eating Disorders? A Cohort Study

Krantz, Mori J.; Blalock, Dan V.; Tanganyika, Kundai; Farasat, Morteza; McBride, Jennifer; Mehler, Philip S.

doi:10.1016/j.amjmed.2020.02.015

Cited by 29 publications

(23 citation statements)

References 27 publications

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“…Thus, while we do believe that patients with anorexia nervosa may have greater QT dispersion than controls, QT dispersion was not the intent of the current study where hypokalemia was a primary driver of delayed repolarization, which is an extrinsic factor in anorexia nervosa. 1 We concur that the best evidence to date on the presumed mechanism of sudden cardiac death in anorexia nervosa is bradyarrhythmias, in the study by Farasat et al 4 This further supports our contention that bradyarrhythmias are more likely to underlie the high risk of sudden death than QTc prolongation and ventricular tachyarrhythmias.…”

supporting

confidence: 84%

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Krantz

Farasat

Mehler

2021

The American Journal of Medicine

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supporting

confidence: 84%

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Krantz

Farasat

Mehler

2021

The American Journal of Medicine

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“…Some patients with eating disorders may be able to adapt to severe chronic hypokalemia [4]. In other patients, however, hypokalemia can lead to life-threatening conditions, e.g., QTc-interval prolongation [5], ventricular brillation [6,7], torsades de pointes [8], acute kidney injury [9], and interstitial nephritis [10,11]. Regarding mechanisms responsible for hypokalemia, binge-purge behavior and laxative/diuretic abuse are believed to induce hypokalemia [3,12] via gastrointestinal uid loss and the associated loss of renal potassium in the urine [13].…”

Section: Discussionmentioning

confidence: 99%

Hypokalemia in Patients With Eating Disorders Is Associated With Binge-Purge Behavior, Lower Body Mass Index, and Hypoalbuminemia ~Predicting Hypokalemia During Refeeding~

Funayama¹,

Mimura²,

Takata³

et al. 2021

Preprint

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Aim To identify potential mechanisms underlying hypokalemia in patients with eating disorders Background Hypokalemia is frequently found in patients with eating disorders and sometimes leads to life-threatening conditions. The mechanisms underlying hypokalemia have yet to be elucidated except for binge-purge behavior, although other factors, e.g., malnutrition and refeeding, are proposed to induce hypokalemia. In this study, we investigated factors associated with hypokalemia during acute treatment of patients with eating disorders. Methods We recruited 52 independent patients from 89 admissions with eating disorders (body mass index, 13.0 ± 3.3) and analyzed serum potassium levels at admission. Similarly, 66 admissions with > 1-week hospitalization were recruited to determine the lowest potassium levels during the refeeding period. We analyzed these levels with multiple linear regression analysis with explanatory variables, including data upon admission and treatment-related indicators. Results A lower serum potassium level at admission and a lower nadir potassium level during refeeding were associated with a lower body mass index, hypoalbuminemia, and binge-purge behavior. Similar results were obtained when the analysis included restrictive or binge-purge types as well as the independent patient group. The lowest potassium levels during the refeeding period was observed an average of 2.5 days after admission. Conclusions Thus lower body mass index, hypoalbuminemia, and binge-purge behavior might predict hypokalemia among patients with eating disorders both at admission and during refeeding. Our study is the first to demonstrate that malnutrition and refeeding themselves might induce hypokalemia among patients with eating disorders. These factors might be used as indicators to guide clinical approaches for controlling serum potassium levels during refeeding.

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“…Previous studies have reported conflicting results on whether QTc prolongation is inherent in AN [97][98][99][100]. Recent studies, however, have reported consistent findings of normal QTc in patients with AN, including a meta-analysis of 964 patients and a cohort study of 1026 patients, using a variety of QTc correcting formulas [97,98].…”

Section: Cardiovascular Complications In Anorexia Nervosamentioning

confidence: 99%

A Comprehensive Review of Complications and New Findings Associated with Anorexia Nervosa

Puckett

Grayeb

Khatri

et al. 2021

JCM

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Anorexia nervosa is a complex and deadly psychiatric disorder. It is characterized by a significant degree of both co-occurring psychiatric diseases and widespread physiological changes which affect nearly every organ system. It is important for clinicians to be aware of the varied consequences of this disorder. Given the high rate of mortality due to AN, there is a need for early recognition so that patients can be referred for appropriate medical and psychiatric care early in the course of the disorder. In this study, we present a comprehensive review of the recent literature describing medical findings commonly encountered in patients with AN. The varied and overlapping complications of AN affect pregnancy, psychological well-being, as well as bone, endocrine, gastrointestinal, cardiovascular, and pulmonary systems.

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Is QTc-Interval Prolongation an Inherent Feature of Eating Disorders? A Cohort Study

Cited by 29 publications

References 27 publications

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Hypokalemia in Patients With Eating Disorders Is Associated With Binge-Purge Behavior, Lower Body Mass Index, and Hypoalbuminemia ~Predicting Hypokalemia During Refeeding~

A Comprehensive Review of Complications and New Findings Associated with Anorexia Nervosa

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