Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition

Öcal, Burhan; Ünal, Şükrü; Zorlu, Pelin; Teziç, H. Tahsin; Oğuz, Deniz

doi:10.1046/j.1440-1754.2001.00566.x

Cited by 44 publications

(58 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This comes in agreement with Ocal et al (2001) who reported that the diastolic function indices were not significantly affected in malnourished patients. Fioretto et al (2002) also reported that there is a geometric alteration of the left ventricle with preserved ventricular compliance and distensibility despite increased passive myocardial stiffness.…”

Section: Discussionsupporting

confidence: 93%

“…However, some patients showed borderline systolic function. This is in agreement with Ocal et al (2001). Similarly, Kothari et al (1992) did not find any evidence of systolic dysfunction in their patients, except in those with extremely severe PEM.…”

Section: Discussionsupporting

confidence: 81%

“…This was also reported by Ocal et al (2001) who stated that the cardiac output was reduced in proportion to the decrease in body size of patients; therefore, cardiac index was not significantly different between the patients and the control subjects. On the contrary, Caddell (2001) reported that starvation for 6 months resulted in a decrease in cardiac index.…”

Section: Discussionsupporting

confidence: 80%

“…In the same respect Cunha et al (2002) recorded that malnourished individuals have lighter hearts. Ocal et al (2001) stated that the most significant reduction in LV mass, septal and postwall thickness was found in KWO group. In addition, the cardiac involvement in patients with marasmus and marasmic KWO was similar in the study conducted by Kothari et al (1992).…”

Section: Discussionmentioning

confidence: 95%

See 3 more Smart Citations

Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery

et al. 2005

View full text Add to dashboard Cite

Background and objectives: The pathogenesis of different malnutrition diseases was suggested to affect the heart. This study was designed to detect cardiac affection in protein energy malnutrition (PEM) patients, whether clinically or by electrocardiogram (ECG) and echocardiogram, and to assess the value of the cardiac marker troponin I in patients at risk of myocardial injury with special emphasis on the effect of nutritional rehabilitation. Patients and methods: The present study was carried out on 30 PEM infants (16 nonedematous -14 edematous) and 10 apparently healthy age and sex-matched infants acting as the control group. All studied infants were subjected to full history taking laying stress on dietetic history, thorough clinical and anthropometric measurements. Echocardiography and ECG were also performed. Laboratory investigations were performed including complete blood count, CRP, total proteins, albumin, liver and kidney functions as well as estimation of troponin-I in blood by immulite. Following initial evaluation, all malnourished infants were subjected to nutritional rehabilitation program for approximately 8 weeks, after which the patients were reevaluated using the same preinterventional parameters. Results: The results of the present study demonstrated that electrical properties of myocardium assessed by ECG showed significant decrease of R wave and QTc interval in patients compared to controls with significant improvement after nutritional rehabilitation. Echocardigraphic changes showed that cardiac mass index was significantly lower in both groups of malnourished cases compared to the controls with significant increase after nutritional rehabilitation. The study showed that the parameters of left ventricular (LV) systolic function which are the ejection fraction, fractional shortening and velocity of circumferential fiber shortening were not significantly reduced in patients compared to the controls. The diastolic function also showed no significant difference in the E wave/A wave (e/a) ratio between patients and controls. However, the systolic time interval showed significantly higher LV pre-ejection index in patients in comparison to controls. Edematous and nonedematous cases did not show any significant differences in ECG and echocardigraphic data before or after nutritional rehabilitation. The hearts of two severely affected patients uniquely demonstrated marked decrease of LV end diastolic diameter (LEVDd) together with the detection of troponin-I in their sera. Conclusion: We can conclude that malnutrition, regardless of its type, has a definite effect on cardiac volume, muscle mass, as well as the electrical properties of the myocardium. The systolic functions of the heart are affected more than the diastolic functions and this affection becomes manifest only in severe cases and may constitute a bad prognostic parameter thus necessitating more intense management and strict follow-up of such cases.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Effects of protein supply in pregnancy on left ventricular function have been described in rats (8). Similarly, infants and children suffering from protein-energy malnutrition have been shown to have reduced left ventricular mass (LVM) and function (9)(10)(11) proportional to body surface (10). In animal models, early life overnutrition has been associated with left ventricular hypertrophy (12).…”

mentioning

confidence: 99%

Higher protein intake increases cardiac function parameters in healthy children: metabolic programming by infant nutrition—secondary analysis from a clinical trial

et al. 2016

View full text Add to dashboard Cite

Background: Protein intake may modulate cardiac structure and function in pathological conditions, but there is a lack of knowledge on potential effects in healthy infants. Methods: Secondary analysis of an ongoing randomized clinical trial comparing two groups of infants receiving a higher (HP) or lower (LP) protein content formula in the first year of life, and compared with an observational group of breastfed (BF) infants. Growth and dietary intake were assessed periodically from birth to 2 y. Insulin-like growth factor 1 (IGF-1) axis parameters were analyzed at 6 mo in a blood sample. At 2 y, cardiac mass and function were assessed by echocardiography. results: HP infants (n = 50) showed a higher BMI z-score at 2 y compared with LP (n = 47) or BF (n = 44). Cardiac function parameters were increased in the HP group compared with the LP and were directly related to the protein intake during the first 6 mo of life. Moreover, there was an increase in free IGF-1 in the HP group at 6 mo. conclusion: A moderate increase in protein supply during the first year of life is associated with higher cardiac function parameters at 2 y. IGF-1 axis modifications may, at least in part, underlie these effects. t here is compelling evidence that the type of nutritional exposure in early periods of an organism's development may affect the structure and function of body tissues later in life (1,2). Protein intake may play a key role in modulating body mass and function of various organs and systems (3,4). This influence can be exerted by a direct effect on the target organs (5) and via the modulation of whole body size (6) resulting in functional load of vital organs. Recent evidence indicates that feeding infant formulas with higher protein (HP) content resulted in an increased kidney volume, with a direct effect on kidney function, and an increase in whole body mass (3,7). One of the target organs affected by early protein intakes is the heart, the development of which occurs in an early embryonic phase. As such, early postnatal nutrition would affect growth since this is the period in which the fastest growth of the body and organs takes place. Effects of protein supply in pregnancy on left ventricular function have been described in rats (8). Similarly, infants and children suffering from protein-energy malnutrition have been shown to have reduced left ventricular mass (LVM) and function (9-11) proportional to body surface (10). In animal models, early life overnutrition has been associated with left ventricular hypertrophy (12). Investigations have been conducted on cardiac function parameters under extreme protein supply situations, but data are lacking on the effect of normal protein supplies on these parameters.Proteins serve as structural substrates for heart tissue development. However, proteins can also affect the growth of the heart through a systemic stimulation of the constituents of the insulin-like growth factor 1 (IGF-1) axis. The rationale in suggesting this mechanism is based on the observation that increased p...

show abstract

Assessment of Myocardial Function in Kenyan Children With Severe, Acute Malnutrition

et al. 2019

View full text Add to dashboard Cite

Key Points Question Do high-risk African children with severe malnutrition show abnormal myocardial function consistent with biventricular failure and/or life-threatening arrhythmias? Findings In a longitudinal case-control study of 88 children with severe, acute malnutrition, no evidence was found that malnourished children were at greater risk of cardiac dysfunction or clinically significant arrhythmias than nonmalnourished controls. Myocardial function was similar in the 2 marasmus and kwashiorkor clinical phenotypes, and myocardial indices following intravenous rehydration indicated fluid-responsive changes with no child developing fluid overload. Meaning Research is needed to address current guidelines restricting rehydration for severe gastroenteritis to oral therapy.

show abstract

Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition

Abstract: We demonstrated that LV Mass and cardiac output were reduced in proportion to decrease in body size in patients with PEM, and LV systolic and diastolic functions were preserved in atrophic hearts.

Cited by 44 publications

References 12 publications

Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery

Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery

Higher protein intake increases cardiac function parameters in healthy children: metabolic programming by infant nutrition—secondary analysis from a clinical trial

Assessment of Myocardial Function in Kenyan Children With Severe, Acute Malnutrition

Contact Info

Product

Resources

About