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Increased energy expenditure in infants with cyanotic congenital heart disease
C A Leitch1, C A Karn, R J Peppard
1Department of Pediatrics, the Section of Neonatal-Perinatal Medicine and the Section of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Infants with cyanotic congenital heart disease (CCHD) experience reduced weight gain. Increased total energy expenditure (TEE), not resting energy expenditure (REE), is a key factor contributing to this growth deficit in CCHD infants.
Area of Science:
- Pediatrics
- Cardiology
- Metabolism
Background:
- Infants with cyanotic congenital heart disease (CCHD) often exhibit suboptimal weight gain.
- Understanding energy balance is crucial for managing growth in these vulnerable infants.
Purpose of the Study:
- To longitudinally assess energy intake, resting energy expenditure (REE), and total energy expenditure (TEE) in infants with CCHD.
- To investigate the relationship between energy expenditure and reduced growth in infants with CCHD.
Main Methods:
- Longitudinal study comparing 10 infants with uncorrected CCHD to 12 healthy controls.
- Indirect calorimetry for REE measurement and doubly labeled water method for TEE and energy intake assessment.
- Measurements taken at 2 weeks and 3 months of age.
Main Results:
- Infants with CCHD showed significantly lower weight at both 2 weeks and 3 months.
- No significant differences in energy intake or REE were observed between groups.
- Total energy expenditure (TEE) was significantly higher in the CCHD group at 3 months (93.6 vs 72.2 kcal/kg/d).
Conclusions:
- Increased total energy expenditure (TEE) is a primary contributor to reduced growth in infants with CCHD.
- Resting energy expenditure (REE) does not appear to be the main driver of growth impairment in this population.
Abstract:
Infants with cyanotic congenital heart disease (CCHD) often have reduced weight gain compared with infants in control groups. Our purpose was to conduct a longitudinal study of energy intake, resting energy expenditure (REE), and total energy expenditure (TEE) of a group of infants with CCHD. We hypothesized that increased REE and TEE and decreased energy intake in these infants would lead to reduced growth. Ten infants with uncorrected CCHD and 12 infants in a control group were studied at 2 weeks of age and again at 3 months. Indirect calorimetry was used to determine REE; the doubly labeled water method was used to determine TEE and intake. At 2 weeks and 3 months of age, infants with CCHD weighed significantly less than infants in the control group. No significant difference was seen in energy intake or REE between groups during either period. TEE was slightly but not statistically increased in the CCHD group at 2 weeks (72.6 +/- 17.4 vs 59.8 +/- 10.9 kcal/kg/d) and significantly increased at 3 months (93.6 +/- 23.3 vs 72.2 +/- 13.2 kcal/kg/d, P