Cardiac function during weight restoration in anorexia nervosa

Fifteen anorexia nervosa patients were evaluated on hospitalization at their lowest weights; 10 were restudied after 25% of their weight deficit had been restored and five at 75% weight restoration. Cardiac function improved with weight gain, but different aspects of cardiac performance varied in their course of recovery. Restoration of normal cardiac rhythm occurred early in weight gain. Left ventricular mass index assessed by echocardiogram increased significantly by 25% weight restoration, while other echocardiographic abnormalities, including mitral valve prolapse, did not change markedly during weight recovery. Overall functional exercise capacity improved, but not until 75% of weight restoration. Consistent with the concept that systolic function lags in recovery, resting left ventricular ejection fraction (LVEF) actually demonstrated a trend to decline by the time 25% of the weight deficit was restored.