Excessive physical activity in young girls with restrictive-type anorexia nervosa: its role on cardiac structure and performance

  • Lucia BilleciEmail author
  • Elena Brunori
  • Silvia Scardigli
  • Olivia Curzio
  • Sara Calderoni
  • Sandra Maestro
  • Maria Aurora Morales
Original Article



The aim of this study was to investigate the influence of hyperactivity on left ventricular mass (LVM) in Anorexia Nervosa restricting-type (AN-R) and the correlation between LVM and auxologic parameters/circulating hormones.


Echocardiography was performed in 44 AN-R girls, subgrouped in 24 hyperactive (ANH+) and 20 non-hyperactive (ANH−), and in 20 controls (HC). LVM indexed to Body Surface Area (LVMi) and LVM indexed to height (LVMh) were calculated.


LVMi and LVMh were significantly lower in the AN-R subjects compared to HC. Moreover, both LVMi and LVMh were higher in the ANH+ than in the ANH−. In the HC, LVMi was higher when compared to the ANH− subjects than to the ANH+. Stepwise analysis revealed that in the ANH+ group, fT4 was the only independent predictor of LVMh, while in the ANH− group, height was the only independent predictors of LVMi.


Despite its negative influence on disease severity and outcome, hyperactivity from the standpoint of cardiac function makes the LVM of AN-R young girls more similar to HC.

Level of evidence

Level III, case–control study.


Anorexia nervosa restricting-type Adolescents Hyperactivity Echocardiography Left ventricular mass 



We would like to thank Dr. Giampiero Igli Baroncelli from the Pediatric Unit I, University of Pisa, Italy, for providing DEXA data.

Compliance with ethical standards


This work was supported by grant from the IRCCS Stella Maris Foundation (Ricerca Corrente, and the “5 × 1000” voluntary contributions, Italian Ministry of Health).

Conflict of interest

All the authors declare that they have no conflict of interest to disclose.

Ethical approval

The study conformed to the Declaration of Helsinki and was approved by the IRCCS Stella Maris Institutional Ethical Committee.

Informed consent

An informed consent was obtained from each subject and from a parent or guardian.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Institute of Clinical PhysiologyNational Research Council of Italy (CNR)PisaItaly
  2. 2.IRCCS Stella Maris FoundationCalambroneItaly
  3. 3.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly

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