ECHOCARDIOGRAPHIC CHANGES IN PATIENTS WIT H ANOREXIA-NERVOSA

Objective: To examine to what extent the condition of chronic malnutri tion of anorexia nervosa leads to changes of the heart. Methods: Using 1- and 2-dimensional echocardiography we collected parameters to dete rmine the size and function of the heart, and the thickness of the myo cardium of 81 patients with anorexia nervosa. Thereover we investigate d the occurence of mitral valve prolapse and pericardial effusion. In a cross-sectional sample of hospitalised patients we put the measured heart parameters in relation to body weight. Subsequently we conducted a longitudinal study of 44 of these 81 patients to find out how these parameters changed with increasing body weight. Results: In the cross -sectional sample we found that the parameters always remained within normals, provided normals were related to body weight. This also impli ed to patients with extreme underweight. A mitral valve prolapse was d etected in 6 of 81 patients (7,5 %), and a pericardial effusion in 16 of 81 patients (20 %). In the longitudinal study the cardiac parameter s increased with increasing body weight, but to a lesser degree than w eight. There were no changes for the mitral valve prolapse whereas the number and size of pericardial effusion clearly decreased. Conclusion : Chronic malnutrition in anorexia nervosa leads to significant change s of the heart. These are, however, less significant than weight loss. The mitral valve prolapse ist not dependent on underweight. With incr easing body weight most of the cardiac parameters tend to normalize al beit at slower pace than body weight. None of these changes were dange rous for the patients even for those with extreme underweight. Therefo re a specific treatment was never found to be necessary.