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Increased QT variability in patients with anorexia nervosa—An indicator for increased cardiac mortality?

  1. Mandy Koschke1,2,†,
  2. Michael K. Boettger MD3,†,
  3. Claudia Macholdt1,
  4. Steffen Schulz4,
  5. Vikram K. Yeragani MD5,6,
  6. Andreas Voss PhD4,
  7. Karl-Jürgen Bär MD1,7,*

Article first published online: 8 OCT 2009

DOI: 10.1002/eat.20765

Issue

International Journal of Eating Disorders

International Journal of Eating Disorders

Volume 43, Issue 8, pages 743–750, December 2010

Additional Information

How to Cite

Koschke, M., Boettger, M. K., Macholdt, C., Schulz, S., Yeragani, V. K., Voss, A. and Bär, K.-J. (2010), Increased QT variability in patients with anorexia nervosa—An indicator for increased cardiac mortality?. Int. J. Eat. Disord., 43: 743–750. doi: 10.1002/eat.20765

Author Information

  1. 1

    Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany

  2. 2

    Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany

  3. 3

    Institute of Physiology I, University Hospital, Jena, Germany

  4. 4

    Department of Medical Engineering, University of Applied Sciences, Jena, Germany

  5. 5

    Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan

  6. 6

    Department of Psychiatry, University of Alberta, Edmonton, Canada

  7. 7

    Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr-University, Bochum, Germany

  1. †

    The first two authors contributed equally to this work.

*Philosophenweg 3, Jena 07743, Germany

  1. †

    The first two authors contributed equally to this work.

Publication History

  1. Issue published online: 10 NOV 2010
  2. Article first published online: 8 OCT 2009
  3. Manuscript Accepted: 25 AUG 2009

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Keywords:

  • anorexia;
  • arrhythmia;
  • autonomic dysbalance;
  • vagal;
  • cardiac mortality

Abstract

Objective

Increased mortality in anorexia nervosa is associated with autonomic dysfunction and prolongation of the QT interval. In this study, we examined the relative importance of repolarization abnormalities and vagal modulation of heart rate. In particular, we hypothesized that patients with anorexia nervosa show increased QT interval variability, particularly since this measure has been shown to correlate with serious cardiac arrhythmias.

Method

We assessed linear and nonlinear heart rate variability (HRV) parameters as well as measures of QT variability in 20 female patients with anorexia nervosa and 20 controls. In patients, parameters were correlated with serum electrolytes.

Results

QT variability was significantly increased in the patient group and correlated negatively with serum potassium concentrations. HRV measures showed a shift of autonomic balance towards vagal predominance.

Discussion

The increase in QT variability might at least in part account for the higher risk of cardiac arrhythmias in patients with anorexia nervosa. Once validated in a prospective study design, parameters of QT variability might serve as surrogate markers for arrhythmia risk stratification in anorexia nervosa. Supplementation with potassium might normalize QT variability abnormalities. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:743–750

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