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Risk for prolonged QT interval and associated outcomes in children with early restrictive eating patterns

Published online by Cambridge University Press:  02 June 2015

Karine Guerrier*
Affiliation:
Department of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
Laurie Mitan
Affiliation:
Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
Yu Wang
Affiliation:
Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
Richard J. Czosek
Affiliation:
Department of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
*
Correspondence to: K. Guerrier, DO, MPH, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH 45229, United States of America. Tel: +513-636-4432; Fax: +513-636-3952; E-mail: [email protected]

Abstract

Aim

This study aimed to describe the frequency of QTc prolongation in children with restrictive eating disorders early in the course of disease admitted for inpatient therapy, to determine the frequency of associated ventricular arrhythmia, and to evaluate the relationship between QTc interval and concomitant electrolyte abnormalities and rate of weight loss.

Methods

This was a retrospective cohort study of patients aged 11–25 years with early restrictive eating disorders.

Results

In all, 82 patients met the inclusion criteria (84% female). In total, 9.8% had prolonged QTc interval during hospitalisation. Patients with prolonged QTc had significantly higher resting heart rates (p=0.006), but there was no association with hypokalaemia (p=0.31), hypomagnesaemia (p=0.43), hypophosphataemia (p=1), or rate of weight loss (p=1).

Conclusion

Mild QTc prolongation in patients with restrictive eating disorders is not related to electrolyte abnormalities or rate of weight loss in this population, suggesting that investigation about other potential risk factors of prolonged QTc interval may be warranted.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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References

1. American Psychiatric Association and American Psychiatric Association. Task Force on DSM-IV. Diagnostic and statistical manual of mental disorders: DSM-IV-TR, 4th edn. American Psychiatric Association, Washington, DC, 2000.Google Scholar
2. Rosling, AM, Sparen, P, Norring, C, von Knorring, AL. Mortality of eating disorders: a follow-up study of treatment in a specialist unit 1974–2000. Int J Eat Disord 2011; 44: 304310.Google Scholar
3. Krantz, MJ, Sabel, AL, Sagar, U, et al. Factors influencing QT prolongation in patients hospitalized with severe anorexia nervosa. Gen Hosp Psychiatry 2012; 34: 173177.Google Scholar
4. Neumarker, KJ. Mortality and sudden death in anorexia nervosa. Int J Eat Disord 1997; 21: 205212.Google Scholar
5. Durakovic, Z, Durakovic, A, Korsic, M. Changes of the corrected Q-T interval in the electrocardiogram of patients with anorexia nervosa. Int J Cardiol 1994; 45: 115120.Google Scholar
6. Lesinskiene, S, Barkus, A, Ranceva, N, Dembinskas, A. A meta-analysis of heart rate and QT interval alteration in anorexia nervosa. World J Biol Psychiatry 2008; 9: 8691.Google Scholar
7. Macias-Robles, MD, Perez-Clemente, AM, Macia-Bobes, C, Alvarez-Rueda, MA, Pozo-Nuevo, S. Prolonged QT interval in a man with anorexia nervosa. Int Arch Med 2009; 2: 23.CrossRefGoogle Scholar
8. Mehler, PS, Krantz, MJ. QT dispersion in anorexia nervosa. Am J Cardiol 2005; 96: 1034.Google Scholar
9. Nahshoni, E, Weizman, A, Yaroslavsky, A, Toledano, A, Sulkes, J, Stein, D. Alterations in QT dispersion in the surface electrocardiogram of female adolescents diagnosed with restricting-type anorexia nervosa. J Psychosom Res 2007; 62: 469472.CrossRefGoogle ScholarPubMed
10. Koschke, M, Boettger, MK, Macholdt, C, et al. Increased QT variability in patients with anorexia nervosa – an indicator for increased cardiac mortality? Int J Eating Disord 2010; 43: 743750.CrossRefGoogle ScholarPubMed
11. Krantz, MJ, Donahoo, WT, Melanson, EL, Mehler, PS. QT interval dispersion and resting metabolic rate in chronic anorexia nervosa. Int J Eating Disord 2005; 37: 166170.Google Scholar
12. Takimoto, Y, Yoshiuchi, K, Kumano, H, et al. QT interval and QT dispersion in eating disorders. Psychother Psychosom 2004; 73: 324328.Google Scholar
13. Facchini, M, Sala, L, Malfatto, G, Bragato, R, Redaelli, G, Invitti, C. Low-K+ dependent QT prolongation and risk for ventricular arrhythmia in anorexia nervosa. Int J Cardiol 2006; 106: 170176.CrossRefGoogle ScholarPubMed
14. Gottdiener, JS, Gross, HA, Henry, WL, Borer, JS, Ebert, MH. Effects of self-induced starvation on cardiac size and function in anorexia nervosa. Circulation 1978; 58: 425433.Google Scholar
15. Ulger, Z, Gurses, D, Ozyurek, AR, Arikan, C, Levent, E, Aydogdu, S. Follow-up of cardiac abnormalities in female adolescents with anorexia nervosa after refeeding. Acta Cardiologica 2006; 61: 4349.Google Scholar
16. Rosen, DS, American Academy of Pediatrics Committee on A. Identification and management of eating disorders in children and adolescents. Pediatrics 2010; 126: 12401253.CrossRefGoogle ScholarPubMed
17. American Psychiatric Association and American Psychiatric Association. DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Arlington, VA, 2013.Google Scholar
18. Goldenberg, I, Moss, AJ, Zareba, W. QT interval: how to measure it and what is “normal”. J Cardiovasc Electrophys 2006; 17: 333336.Google Scholar
19. Johnson, JN, Ackerman, MJ. QTc: how long is too long? Brit J Sports Med 2009; 43: 657662.Google Scholar
20. Van Dorn, CS, Johnson, JN, Taggart, NW, Thorkelson, L, Ackerman, MJ. QTc values among children and adolescents presenting to the emergency department. Pediatrics 2011; 128: 395401.Google Scholar
21. Kuczmarski, RJ, Ogden, CL, Grummer-Strawn, LM, et al. CDC growth charts: United States. Advance Data 2000; 314: 127.Google Scholar
22. Mont, L, Castro, J, Herreros, B, et al. Reversibility of cardiac abnormalities in adolescents with anorexia nervosa after weight recovery. J Am Acad Child Adoles Psychiatry 2003; 42: 808813.Google Scholar
23. Roche, F, Barthelemy, JC, Mayaud, N, et al. Refeeding normalizes the QT rate dependence of female anorexic patients. Am J Cardiol 2005; 95: 277280.Google Scholar