Risk factors and cardiovascular manifestations of pericardial effusion in adolescents with anorexia nervosa: a retrospective case-control study

Background Pericardial effusion is frequently observed in patients with anorexia nervosa. This study compared general, echocardiographic, laboratory, and electrocardiographic findings in adolescents with anorexia nervosa, with and without pericardial effusion, and healthy controls. It also sought to identify risk factors associated with pericardial effusion in adolescents with anorexia nervosa. Methods We analyzed 29 female adolescents with anorexia nervosa, including 14 with pericardial effusion, and 26 healthy controls. Clinical and laboratory data were compared. A subgroup analysis was conducted to investigate the correlation between variables and pericardial effusion using univariate analysis and Cox proportional hazards regression. Results Compared with controls, adolescents with anorexia nervosa showed significantly lower systolic and diastolic blood pressure, left ventricular mass, left ventricular mass index, mitral inflow E and A waves, medial mitral annular e′ velocity, platelet count, phosphorus and triiodothyronine levels, and heart rate, but higher serum sodium and cholesterol levels and greater QRS axis deviation. Patients with anorexia nervosa and pericardial effusion had significantly lower calcium, phosphorus, and free thyroxine levels and higher cholesterol and thyroid-stimulating hormone levels than those without pericardial effusion. Univariate analysis revealed lower calcium, free thyroxine, and phosphorus levels, a higher mitral E/A ratio, and a prolonged PR interval as significant risk factors. In multivariate analysis, lower calcium remained an independent predictor. Conclusions Pericardial effusion is a common finding in this population and low calcium levels appear to be an independent risk factor for its development.