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Published on: May 24, 2016
Myocardial dysfunction in malnourished children
Nagla Hassan Abu Faddan1, Khalid Ibrahim El Sayh, Hamdy Shams
1Department of Pediatrics, Egypt.
Insights
Malnourished children exhibit reduced heart muscle mass and impaired systolic function. Elevated cardiac troponin T (cTnT) levels indicate cardiomyocyte damage and predict poor prognosis in severe malnutrition.
Area of Science:
- Pediatric Cardiology
- Nutritional Science
- Biomarkers
Background:
- Malnutrition in children leads to significant body composition changes.
- These alterations can manifest as cardiac abnormalities, impacting cardiovascular health.
Purpose of the Study:
- To determine the incidence of myocardial damage in malnourished children.
- To assess cardiac function using echocardiography and cardiac troponin T (cTnT) levels.
Main Methods:
- Compared 45 malnourished children with 25 healthy controls.
- Analyzed complete blood count, liver/kidney function, electrolytes, and cTnT.
- Performed echocardiographic evaluation for all malnourished children.
Main Results:
- Malnourished children had significantly lower left ventricular (LV) mass.
- Severe malnutrition impaired LV systolic function and ejection fraction (EF).
- Elevated cTnT (24.44%) in severe malnutrition correlated with poorer outcomes and higher mortality.
Conclusions:
- Reduced LV mass is characteristic of malnourished children.
- Severe malnutrition significantly impairs LV systolic function.
- Elevated cTnT levels are a significant indicator of cardiomyocyte damage and prognosis in malnourished children.
Background:
Malnourished children suffer several alterations in body composition that could produce cardiac abnormalities.
Aim:
The aim of the present study was to detect the frequency of myocardial damage in malnourished children as shown by echocardiography and cardiac troponin T (cTnT) level.
Methods:
Forty-five malnourished infants and young children (mean±SD of age was 11.24 ±7.88 months) were matched with 25 apparently healthy controls (mean±SD of age was 10.78±6.29 months). Blood sample was taken for complete blood picture, liver and kidney function tests, serum sodium, potassium, calcium levels and cTnT. All the malnourished children were subjected to echocardiographic evaluation.
Results:
Malnourished children showed a significantly lower left ventricular (LV) mass than the control group. The LV systolic functions were significantly impaired in patients with severe malnutrition. The cTnT level was higher than the upper reference limits in 11 (24.44%) of the studied malnourished children and all of them had a severe degree of malnutrition. The cTnT level was significantly higher in patients with anemia, sepsis and electrolyte abnormalities and it correlated negatively with LV ejection fraction (EF). Six of the studied children with high cTnT levels (54.5%) died within 21 days of treatment while only one case (2.9%) with normal level of cTnT died within the same period.
Conclusions:
LV mass is reduced in malnourished children. Children with severe malnutrition have a significant decrease in LV systolic functions. Elevated cTnT levels in malnourished children has both diagnostic and prognostic significance for cardiomyocyte damage.
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