To Study Structural and Functional Cardiac Changes in Children with Severe Acute Malnutrition

Abstract

BACKGROUND Severe acute malnutrition (SAM) is one of the most important health problems affecting hundreds of millions of children in the world. Malnourished children suffer several alterations in body composition, with loss of heart and skeletal muscle mass, complicated by electrolyte abnormalities and mineral or vitamin deficiencies that could produce cardiac abnormalities. The present study was undertaken to compare cardiac structural and functional parameters in severe malnutrition and age matched control in Indian children. We wanted to assess the structural and functional cardiac changes in children with severe acute malnutrition. METHODS This is a case control study conducted in paediatric cardiology clinic and severe malnutrition treatment unit (SMTU) of department of paediatrics SSMC associated Gandhi Memorial Hospital, Rewa, M. P. 50 SAM children admitted in SMTU and 50 normal children aged 6 months to 60 months were included in the study. Structural and functional cardiac parameters in SAM children (Cases) were compared with those of normal children (Controls) on the basis of Echocardiography. For structural cardiac changes, interventricular septum thickness (IVS), left ventricular internal diameter (LVID), left ventricular posterior wall thickness (LVPW) and left ventricular mass (LVM) were measured. For functional cardiac changes ejection fraction (EF), fractional shortening (FS) and stroke volume (SV) were measured. RESULTS In the present study, all structural parameters viz the 'IVSs' during systole, IVSd during diastole, LVPWs during systole, LVPWd during diastole, and LVM, all parameters were significantly reduced in SAM children as compared to normal children and functional changes in the form of ejection fraction, fractional shortening and stroke volume (p<0.0001) were also significantly reduced. CONCLUSIONS There was significant reduction in structural (Thickness of IVS, LVPW and LVM) and functional parameters (EF, FS and SV) in SAM children as compared to normal children.