Ultrasonic tissue characterization of the myocardium in anorexia nervosa

Abstract

Aim: To determine the systodiastolic variations in the integrated backscatter (IBS) signal of the myocardium in patients with anorexia nervosa. Methods: 25 young women (aged 22.4 ± 4.3 y) with overt anorexia nervosa, compared with 25 age‐matched thin and 25 age‐matched control women with body mass index >20 kg m−2, underwent either conventional two‐dimensional echocardiography or analysis of IBS cyclic variations. Results: Compared with thin and control subjects, anorectic patients showed reduced left ventricular mass (LVM: 82.9 ± 17.1 vs 119.9 ± 13.8 and vs 126.12 ± 16.4 g, p < 0.0001; LVM indexed 21.4 ± 3.3 vs 29.4 ± 2.5 and vs 31.2 ± 3.1 g m−2.7, p < 0.0001), and IBS cyclic variations (septum: –0.49 ± 2.18 vs 6.86 ± 1.3 and vs 6.61 ± 1.74 dB, p < 0.0001; posterior wall: 2.77 ± 2.12 vs 7.15 ± 2.12 and vs 7.48 ± 2.23 dB, p < 0.01). Conclusion: Anorexia nervosa is associated with a significant reduction in the cyclic variation in IBS, which is also related to left ventricular hypotrophy. Ultrasonic tissue characterization could give an objective approach for the detection of myocardial structural properties and represent a preclinical index of myocardial dysfunction in anorexia nervosa.

Cardiac abnormalities identified with echocardiography in anorexia nervosa: systematic review and meta-analysis

“…2). 10,12,13,[17][18][19][20]22,25,26,29 This finding was consistent in four of these studies where the anorexia nervosa group was compared with a thin (normal-low BMI) control group (SMD 2.53, 95% CI 1.48-3.59; see Supplementary Fig. 1), 18,20,22,29 and when adults were studied alone (SMD 1.90, 95% CI 1.01-2.80).…”

Cardiac changes in anorexia nervosa

“…Changes in cardiac mass and chamber dimensions present early in anorexia nervosa 15 and have been well studied. Consistently, decreases in left ventricular mass [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and left ventricular end-diastolic and left ventricular end-systolic dimensions 20,23,25,[29][30][31][32][33][34][35] are found; however, some controversy remains regarding some other very specific dimension measures, with some authors finding changes in left ventricular wall thickness [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] or left ventricular posterior wall thickness 2...…”

Cardiovascular complications of anorexia nervosa: A systematic review

“…In addition to reduction in LV mass in AN, one study suggested significant abnormal ultrasonic tissue characterization suggesting pathologic remodeling . A more recent study demonstrated myocardial fibrosis/scar manifested by late gadolinium enhancement on cardiac magnetic resonance imaging (MRI) in nearly a quarter of anorexia nervosa patients compared with no patients in the control group .…”