Echocardiographic changes in anorexia nervosa: a pathophysiological adaptation or a disease?

Area of Science:

• Cardiology
• Eating Disorders
• Medical Imaging

Background:

• Anorexia nervosa (AN) is a severe eating disorder with high cardiac morbidity, affecting up to 80% of patients.
• Cardiac involvement in AN is often assessed via echocardiography, but associations with body weight fluctuations and linear measurements require further investigation.

Purpose of the Study:

• To describe echocardiographic and clinical features in male and female AN patients.
• To evaluate the impact of weight gain on these cardiac parameters.

Main Methods:

• A retrospective, single-center study of 81 AN patients (94% female, mean age 25) treated at a specialized multidisciplinary unit.
• Echocardiographic parameters, including left ventricular mass, volumes, interventricular septum thickness, and pericardial effusion, were analyzed in relation to body mass index (BMI) and changes during weight gain.

Main Results:

• Lower BMI correlated with higher rates of pericardial effusion, smaller left ventricular mass/volume, and thinner interventricular septum.
• Despite reduced absolute values, left ventricular mass and volumes were largely normal when indexed to body surface area.
• Pericardial effusion was associated with mitral valve abnormalities and lower blood cell counts, but not inflammation or low protein.
• Weight gain in 39 patients led to increased left ventricular mass, septum thickness, blood cell counts, and decreased pericardial effusion.

Conclusions:

• Anorexia nervosa patients display a distinct echocardiographic pattern that appears adaptive and proportional to body size.
• Weight restoration significantly improves cardiac dimensions and reduces pericardial effusion in AN patients.
• Echocardiography is crucial for monitoring cardiac status and response to treatment in anorexia nervosa.