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The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa
Objective Anorexia nervosa (AN) patients are at an increased risk of developing cardiac complications including bradyarrhythmias, systolic dysfunction, pericardial effusions, and sudden cardiac death. Although previous echocardiographic studies in AN patients have demonstrated a reduction in overall...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510561/ https://www.ncbi.nlm.nih.gov/pubmed/31123651 http://dx.doi.org/10.7759/cureus.4229 |
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author | Chu, Karen Asselin, Chantal Y Buffo, Ilan Lane, Margo Ludwig, Louis Jassal, Davinder S Schantz, Daryl |
author_facet | Chu, Karen Asselin, Chantal Y Buffo, Ilan Lane, Margo Ludwig, Louis Jassal, Davinder S Schantz, Daryl |
author_sort | Chu, Karen |
collection | PubMed |
description | Objective Anorexia nervosa (AN) patients are at an increased risk of developing cardiac complications including bradyarrhythmias, systolic dysfunction, pericardial effusions, and sudden cardiac death. Although previous echocardiographic studies in AN patients have demonstrated a reduction in overall left ventricular (LV) mass, systolic dysfunction, and silent pericardial effusions, little is known about the role of cardiac magnetic resonance imaging (CMR) in assessing this patient population. The objective of this study was to assess cardiac indices and the presence of myocardial fibrosis in AN patients. Methods Between 2014 and 2015, a cross-sectional pilot study of 16 female patients who met the Diagnostic and Statistics Manual of Mental Disorders, fifth edition (DSM-5) criteria for AN was conducted at a single tertiary care center. Baseline characteristics including age, weight, food restriction behavior, over-exercise, self-induced vomiting, and laxative abuse were collected in the study population. Electrocardiography, transthoracic echocardiography (TTE), and CMR were performed. Results The mean age was 17 years (range: 13-22 years). There were no conduction abnormalities as the average PR interval was 152 ms (range: 130-190 ms) and QTc was 413 ms (range: 360-450 ms). Using TTE, the left ventricular ejection fraction (LVEF) was 54 ± 4% with a lower LV mass/body surface area (BSA) of 56 ± 7g/m(2 )in AN patients as compared to controls. Using CMR, both the mean LVEF of 52 ± 9% and LV mass/BSA of 45 ± 4g/m(2 )were lower in AN patients as compared to controls. Using CMR, both right ventricular ejection fraction (RVEF) of 50 ± 10% and a right ventricular (RV) mass/BSA of 18 ± 3g/m(2 )were smaller in AN patients as compared to controls. There was no evidence of late gadolinium enhancement (LGE) in the study population. Conclusions Young patients with AN have lower cardiac mass and volumes with no evidence of myocardial fibrosis. |
format | Online Article Text |
id | pubmed-6510561 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-65105612019-05-23 The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa Chu, Karen Asselin, Chantal Y Buffo, Ilan Lane, Margo Ludwig, Louis Jassal, Davinder S Schantz, Daryl Cureus Cardiology Objective Anorexia nervosa (AN) patients are at an increased risk of developing cardiac complications including bradyarrhythmias, systolic dysfunction, pericardial effusions, and sudden cardiac death. Although previous echocardiographic studies in AN patients have demonstrated a reduction in overall left ventricular (LV) mass, systolic dysfunction, and silent pericardial effusions, little is known about the role of cardiac magnetic resonance imaging (CMR) in assessing this patient population. The objective of this study was to assess cardiac indices and the presence of myocardial fibrosis in AN patients. Methods Between 2014 and 2015, a cross-sectional pilot study of 16 female patients who met the Diagnostic and Statistics Manual of Mental Disorders, fifth edition (DSM-5) criteria for AN was conducted at a single tertiary care center. Baseline characteristics including age, weight, food restriction behavior, over-exercise, self-induced vomiting, and laxative abuse were collected in the study population. Electrocardiography, transthoracic echocardiography (TTE), and CMR were performed. Results The mean age was 17 years (range: 13-22 years). There were no conduction abnormalities as the average PR interval was 152 ms (range: 130-190 ms) and QTc was 413 ms (range: 360-450 ms). Using TTE, the left ventricular ejection fraction (LVEF) was 54 ± 4% with a lower LV mass/body surface area (BSA) of 56 ± 7g/m(2 )in AN patients as compared to controls. Using CMR, both the mean LVEF of 52 ± 9% and LV mass/BSA of 45 ± 4g/m(2 )were lower in AN patients as compared to controls. Using CMR, both right ventricular ejection fraction (RVEF) of 50 ± 10% and a right ventricular (RV) mass/BSA of 18 ± 3g/m(2 )were smaller in AN patients as compared to controls. There was no evidence of late gadolinium enhancement (LGE) in the study population. Conclusions Young patients with AN have lower cardiac mass and volumes with no evidence of myocardial fibrosis. Cureus 2019-03-11 /pmc/articles/PMC6510561/ /pubmed/31123651 http://dx.doi.org/10.7759/cureus.4229 Text en Copyright © 2019, Chu et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Chu, Karen Asselin, Chantal Y Buffo, Ilan Lane, Margo Ludwig, Louis Jassal, Davinder S Schantz, Daryl The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title | The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title_full | The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title_fullStr | The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title_full_unstemmed | The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title_short | The Role of Cardiac Magnetic Resonance Imaging in Severe Anorexia Nervosa |
title_sort | role of cardiac magnetic resonance imaging in severe anorexia nervosa |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510561/ https://www.ncbi.nlm.nih.gov/pubmed/31123651 http://dx.doi.org/10.7759/cureus.4229 |
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