Cardiac changes in moderately malnourished children and their correlations with anthropometric and electrolyte
Osama El Razaky1, Ahmed Naeem1, Amr Donia1
1Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Insights
Moderate malnutrition in children causes significant electrocardiographic and echocardiographic cardiac changes. These changes are strongly linked to body mass index (BMI) and, to a lesser extent, to electrolyte imbalances, particularly serum calcium.
Area of Science:
- Pediatric Cardiology
- Nutritional Science
- Biomedical Engineering
Background:
- Malnutrition significantly impacts child development.
- Cardiac function can be affected by nutritional status.
Purpose of the Study:
- To assess electrocardiographic and echocardiographic alterations in malnourished children.
- To correlate cardiac changes with anthropometric and electrolyte status.
Main Methods:
- Compared 60 malnourished children with 60 healthy controls.
- Measured weight, BMI, albumin, and electrolytes.
- Performed ECG for QTc/QTd and echocardiography for LV function and mass.
Main Results:
- Malnourished children showed lower weight, BMI, albumin, and calcium.
- Prolonged QTc and QTd were observed in malnourished children.
- Reduced LV function (FS, E'/A', S, MPI, GLSS) and LVMI were significant.
Conclusions:
- Moderate malnutrition induces cardiac changes detectable by ECG and echocardiography.
- Body mass index (BMI) is a strong predictor of these cardiac alterations.
- Electrolyte changes, especially serum calcium, also correlate with cardiac findings.
Objective:
To evaluate electrocardiographic and echocardiographic changes in moderately malnourished children and to correlate them with both anthropometric and electrolyte changes.
Patients And Method:
Sixty moderately malnourished children were taken as patient group, and 60 healthy children of matched age and sex were taken as control group. Weight, height, body mass index (BMI), serum albumin, and electrolytes were measured for all children. Electrocardiographic evaluation for calculated QT (QTc) and QT dispersion (QTd) was performed. Left ventricular (LV) function was also evaluated using conventional echocardiography, tissue Doppler, and strain methods. Left ventricular mass index (LVMI) was also calculated.
Results:
Weight, BMI, serum levels of albumin, total calcium, and ionized calcium were significantly lower, while QTc and QTd were significantly prolonged in malnourished children (P = .001 for all). There was significant reduction in LV fraction shortening (FS), LV E'/A', LV strain (S), LV myocardial performance index (MPI), LV global systolic strain (GLSS), and LVMI (P = .001 for all) in malnourished children. There was significant correlation between BMI and all cardiac variables. Moreover, there was significant positive correlation between serum albumin level and LV E'/A' (P = .02), LV GLSS (P = .03), and LVMI (P = .03).Total and ionized calcium level were significantly correlated with QTc, QTd, and LVMI (P < .05 for all). BMI was the most powerful predictor of these electrocardiographic and echocardiographic changes.
Conclusion:
Cardiac changes were present in moderately malnourished children as documented by electrocardiographic and echocardiographic changes, and these changes are in strong association with BMI and for a lesser extent with electrolyte changes especially serum calcium.
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