Abstract
Background: Eating disorders such as anorexia nervosa present with a significant cardiovascular associated risk of sudden cardiac death. Bradycardia is a serious complication of eating disorders. Methods: Eating Disorder (ED) patients were admitted to a 6-week treatment program and assessed for of heart rate variability (HRV) at entrance to the program and at discharge from hospital. Linear heart rate variability measures were determined using Kubios software from Lead 3 ECG recordings following a 5-minute rest period. Nonparametric statistics were applied and significance set at p < 0.05. Results: No significant differences in HRV parameters were noted for the control group following the 6-week treatment program. For the ED group, mean RR interval length decreased significantly following treatment compared (median ± IQR; -64 ± 76; p = 0.002). Sympathovagal function was abnormal in the ED group on admission but improved following treatment, showing a decrease in RMSSD (median ± IQR; -9 ± 18; p = 0.048) and SD1 (median ± IQR; -6 ± 13; p = 0.048). Sample entropy, a, measure of heart rate complexity did not change significantly. Conclusion: At admission to hospital the ED group was more parasympathetic during rest compared to controls, but they became more sympathetic after the intervention and approached the HRV measures of the controls.
Highlights
Eating disorders (EDs) play a significant role in health care worldwide
Heart rate is controlled by the autonomic nervous system (ANS), which in turn is modulated by the peripheral baroreflex and metabolic factors
We included standing as a factor following work by Kiviniemi et al [17] who suggested that heart rate variability (HRV) should be measured whilst standing in cohorts with increased parasympathetic input due to HRV being sensitive to saturation effects
Summary
Eating disorders (EDs) play a significant role in health care worldwide. EDs are characterized by abnormal eating patterns and perceptual distortions related to food and weight, which in turn results in a significant impairment of physical health and psychosocial functioning [1,2,3]. The study of HRV in patients with ED has provided clinically important information on the integrity and function of the complex physiologic mechanisms controlling heart rate [13,14]. The majority of studies of ED and ANS modulation have concentrated on anorexia nervosa that did not include age-matched controls and only utilized linear HRV methods. The current study explores the effect of a 6-weeks rehabilitation program in patients with ED independent of BMI. Eating disorders such as anorexia nervosa present with a significant cardiovascular associated risk of sudden cardiac death.
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