BACKGROUND & AIMS:
BACKGROUND:Anorexia Nervosa (AN) is an eating disorder characterized by low body weight, distorted body image, and an intense fear of gaining weight. Electrocardiogram (ECG) changes, particularly in the QT interval, have been implicated in AN-associated sudden death but not well defined.
OBJECTIVES:To characterize QT interval changes during exercise in anorexia nervosa.
METHODS:The QT interval was evaluated in a prospective cohort undergoing structured exercise. Patients from the St. Paul's Hospital Provincial Adult Tertiary Eating Disorders Program underwent a 6-minute modified exercise test protocol. A single lead ECG patch recording device was used to record a Lead I equivalent, due to challenges applying standard ECG monitoring in subjects with low body mass. Heart rate (HR) and QT interval were assessed.
RESULTS:Eighteen eating disorder patients (16 female) completed testing (age 31 ± 12 years, BMI 16.5 ± 3.8 kg/m2). Patients were compared to age- and sex-matched healthy controls. HR was similar between patients and controls (baseline: 65 (55-70)bpm vs. 69 (53-73)bpm, p = 0.83; maximum: 110 (94-139) bpm vs. 108 (93-141) bpm, p = 0.96; end recovery: 62 (54-68) bpm vs. 66 (55-75) bpm, p = 0.39). QTc intervals were similar between groups at baseline (381 ± 17 ms vs. 381 ± 46 ms, p = 0.93) and end recovery (397 ± 42 ms vs 398 ± 42 ms, p = 0.91). However, AN patients demonstrated QTc prolongation while controls showed QTc shortening at maximum HR (426 ± 70 ms vs. 345 ± 59 ms, p = 0.001).
CONCLUSION:Low level exercise HR increases are similar between AN patients and controls, but the QTc interval fails to shorten, which may explain the increased arrhythmic risk in AN.
背景与目标:
背景:神经性厌食症(Anorexia Nervosa,AN)是一种饮食失调症,其特征在于低体重,身体形象扭曲以及强烈的体重增加恐惧感。心电图(ECG)的变化,特别是在QT间隔中,与AN相关的猝死有关,但尚未明确。
目的:表征神经性厌食症运动期间QT间期的变化。
方法:在进行结构性锻炼的前瞻性队列中评估QT间隔。来自圣保罗医院省成人三级饮食失调计划的患者接受了为时6分钟的改良运动测试方案。由于在低体重受试者中应用标准ECG监测存在挑战,因此使用单个铅ECG贴片记录设备来记录等效的LeadI。评估心率(HR)和QT间隔。
结果:18名饮食失调患者(16名女性)完成了测试(年龄31±12岁,BMI 16.5±3.8 kg / m2)。将患者与年龄和性别相匹配的健康对照进行比较。患者和对照组之间的HR相似(基线:65(55-70)bpm vs. 69(53-73)bpm,p = 0.83;最大值:110(94-139)bpm vs.108(93-141)bpm, p = 0.96;最终恢复率:62(54-68)bpm与66(55-75)bpm,p = 0.39)。两组之间的QTc间隔在基线(381±17ms vs.381±46ms,p = 0.93)和最终恢复(397±42ms vs 398±42ms,p = 0.91)相似。但是,AN患者表现出QTc延长,而对照组显示最大HR时QTc缩短(426±70ms对345±59ms,p = 0.001)。
结论:低水平运动HR增加在AN患者和对照组之间相似,但是QTc间隔不能缩短,这可以解释AN的心律失常风险增加。