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Echocardiographic findings in adolescents with anorexia nervosa at beginning of treatment and after weight recovery

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Abstract

Anorexia nervosa (AN) is an eating disorder with somatic complications. The aim of the study was to analyse echocardiographic abnormalities in patients with AN at initial examination and after weight restoration. A total of 173 consecutively admitted adolescents (aged 12–17 years), diagnosed with DSM-IV AN (307.1) were evaluated in a child and adolescent psychiatric department of a major university hospital from December 1997 to August 2008. In addition, 40 healthy adolescents of the same age with normal weight were examined. In patients with AN, 34.7% had a pericardial effusion (PE) which was clinically silent. In contrast, none of the controls presented with PE (p < 0.001). No differences across AN subtypes were observed. Patients with PE showed significantly lower body mass index (BMI) (p = 0.016) than patients without PE. They had more prominent low-T3 syndrome (p = 0.003) and longer duration of hospitalisation (p = 0.008) after controlling for BMI at admission. Remission of PE was observed in 88% of the patients after weight restoration. Left ventricular end-diastolic and end-systolic dimensions in AN were significantly lower than in controls (p < 0.001). There were no differences in interventricular septum thickness, posterior wall thickness and fractional shortening. This report indicates that adolescents with AN show cardiac abnormalities in comparison to healthy young women. Furthermore, PE is a frequent cardiac complication in patients with AN and it is associated with BMI, low T3 serum levels and duration of hospitalisation.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Sabrina Kastner, Harriet Salbach-Andrae, Ernst Pfeiffer & Ulrike Lehmkuhl

  2. Department of Psychology, Division of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany

    Babette Renneberg

  3. Department of Pediatrics, Division of Cardiology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Lothar Schmitz

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  1. Sabrina Kastner
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  2. Harriet Salbach-Andrae
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  3. Babette Renneberg
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  4. Ernst Pfeiffer
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Correspondence to Sabrina Kastner.

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Kastner, S., Salbach-Andrae, H., Renneberg, B. et al. Echocardiographic findings in adolescents with anorexia nervosa at beginning of treatment and after weight recovery. Eur Child Adolesc Psychiatry 21, 15–21 (2012). https://doi.org/10.1007/s00787-011-0227-8

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  • DOI: https://doi.org/10.1007/s00787-011-0227-8

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