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Assessment of cardiac function by M-mode echocardiography in selenium-deficient phenylketonuric children
S J Gordon1, S C Latham, J D Spink
1Department of Medicine, Royal Children's Hospital, Herston, Brisbane, Australia.
Insights
Selenium deficiency in children with Phenylketonuria (PKU) did not impair cardiac function. Echocardiography showed normal heart performance at rest and during exercise, indicating no significant cardiac issues in this group.
Area of Science:
- Biochemistry
- Pediatric Cardiology
- Nutritional Science
Background:
- Selenium (Se) deficiency is linked to cardiac and skeletal muscle dysfunction.
- Low Se levels are a concern in certain pediatric populations.
- Phenylketonuria (PKU) management may involve dietary factors affecting Se status.
Purpose of the Study:
- To assess myocardial function in Se-deficient children with PKU.
- To investigate potential cardiac impairment in children with low Se levels.
- To exclude occult left ventricular dysfunction in this cohort.
Main Methods:
- M-mode echocardiography used for myocardial function assessment.
- Assessment performed at rest and after exercise provocation.
- Fractional shortening (FS) and heart rate (HR) were measured in 20 children (aged 2-16 years).
Main Results:
- Children had significantly low Se levels (mean 0.29 mumol/L).
- Resting fractional shortening (FS) was normal (mean 38.1%).
- FS and heart rate (HR) increased significantly with exercise, indicating normal cardiac response.
Conclusions:
- Se-deficient children with PKU demonstrated normal resting cardiac function.
- The normal increase in FS and HR during exercise suggests preserved myocardial contractility.
- Evidence supports the absence of significant cardiac impairment in this group of Se-deficient children.
Abstract:
Selenium (Se) deficiency is associated with cardiac and skeletal muscle dysfunction. Twenty well children aged 2-16 years (10 male) attending the Phenylketonuria (PKU) Clinic at the Royal Children's Hospital, Brisbane, had low Se levels (mean 0.29 +/- 0.02 s.e.m. mumol/L; normal range 0.56-1.16 mumol/L). Their myocardial function was assessed at rest and after exercise provocation by M-mode echocardiography in order to exclude occult left ventricular dysfunction. At rest, fractional shortening (FS) was normal (mean 38.1 +/- 1.1 s.e.m. %, n = 20). After exercise, FS increased significantly (P less than 0.001) from 37.6 +/- 1.4% to 44.3 +/- 1.2%, n = 12). This was associated with a significant rise (P less than 0.001) in heart rate (HR) from 77.3 +/- 3.1 beats/min to 125.8 +/- 5.2 beats/min (n = 12). The normal resting FS and normal increase in FS and HR with exercise is evidence against significant cardiac impairment in this group of Se-deficient children.