{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:39:27Z","timestamp":1787243967497,"version":"build-2736575974"},"reference-count":63,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate heart rate variability (HRV) as a biomarker of autonomic dysfunction in anorexia nervosa (AN), examining differences across clinical stages and the influence of HRV recording duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Quantitative studies comparing HRV parameters between individuals with AN and healthy controls were identified through a systematic search of six databases following PRISMA guidelines. Random\u2010effects meta\u2010analyses and meta\u2010regressions were conducted, with HRV recording duration (5\u2010min vs. 24\u2010h recordings) examined as a moderator. Meta\u2010regression by clinical stage was not feasible due to an insufficient number of studies. Risk of bias was assessed using the Joanna Briggs Institute tool, and certainty of evidence was rated with GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen studies were included, with 16 contributing to the meta\u2010analysis (805 participants). Acute AN was associated with significantly lower heart rate (SMD\u00a0=\u00a0\u22121.807; 95% CI: [\u22123.36, \u22120.26];\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.022) and reduced LF\/HF ratio (SMD\u00a0=\u00a0\u22120.74; 95% CI: [\u22121.179, \u22120.301];\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). These results indicate parasympathetic predominance. Time\u2010domain indices (SDNN and RMSSD) tended to be higher in AN but were not statistically significant and were supported by low\u2010certainty evidence. Meta\u2010regression analyses revealed that short\u2010term (5\u2010min) HRV recordings yielded significant differences for SDNN (SMD\u00a0=\u00a00.539;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008) and HF (SMD\u00a0=\u00a00.679;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, HRV reflects autonomic alterations in AN, particularly in the acute phase characterised by parasympathetic predominance. HRV does not consistently normalise during recovery. These findings are strongly moderated by recording duration. Short\u2010term recordings show more consistent effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/erv.70104","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T06:25:43Z","timestamp":1774333543000},"page":"1171-1183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Heart Rate Variability in Anorexia Nervosa: A Systematic Review and Meta\u2010Analysis on the Moderating Role of Measurement Duration and Clinical Stage"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0767-6377","authenticated-orcid":false,"given":"Marta Victoria","family":"Santiago","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences European University of the Atlantic  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5410-8453","authenticated-orcid":false,"given":"Miguel","family":"Heres","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences European University of the Atlantic  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7009-1567","authenticated-orcid":false,"given":"Cristina","family":"Mazas","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences European University of the Atlantic  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1421-5099","authenticated-orcid":false,"given":"Maria","family":"Fernandez\u2010del\u2010Valle","sequence":"additional","affiliation":[{"name":"Department of Functional Biology Campus del Cristo B University of Oviedo  Oviedo Spain"},{"name":"Health Research Institute of the Principality of Asturias (ISPA)  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4625-2759","authenticated-orcid":false,"given":"Hugo","family":"Olmedillas","sequence":"additional","affiliation":[{"name":"Department of Functional Biology Campus del Cristo B University of Oviedo  Oviedo Spain"},{"name":"Asturian Research Group in Performance Readaptation Training and Health (AstuRES) University of Oviedo  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6845-248X","authenticated-orcid":false,"given":"Susana","family":"Pulgar","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences European University of the Atlantic  Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000227876.19909.48"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.11124\/jbies\u201023\u201000268"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/s19122820"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2013.11.012"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.crd.0000216745.96062.7c"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03327462"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2009.10.026"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2018.06.002"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/ac.70.4.3094647"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40101\u2010016\u20100113\u20107"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010020\u20102433\u20108"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.01.041"},{"key":"e_1_2_11_16_1","article-title":"Anorexia Nervosa","volume":"2009","author":"Fitzpatrick K. 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