ISSN 1016-5169 | E-ISSN 1308-4488
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Echocardiographic Evaluation of Cardiac Functions and Left Ventricular Mass in Children with Protein Energy Malnutrition [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2000; 28(3): 168-173

Echocardiographic Evaluation of Cardiac Functions and Left Ventricular Mass in Children with Protein Energy Malnutrition

Burhan ÖCAL1, Selma ÜNAL1, H.Tahsin TEZİÇ1, Pelin ZORLU1, Deniz OĞUZ1

We studied 30 children (15 males, ı5 females), aged 2 months-2 years (mean 8.5 ± 5.5 months) with protein energy malnutrition (4 kwashiorkor, 7 marasmus-kwashiorkor, ı9 marasmus, of which 2ı were classified as third-degree malnutrition), and compared their left ventricular mass and systolic and diastolic functions to those of 17 healthy, agematched children (mean 7.0 ± 5 . ı months). The mean Ieft ventricu lar mass in the patients was tower than that in the controls (14.5 ± 0.9 vs 19.8 ± 1 .ı , p<0.05). However, left ventricular mass 1 body surface area was not different in patients with PEM and in the control group (52±1.6 vs 53.9±1.9, p>0.05), indicating that left ventricular mass was reduced in proportion to decrease in body size in malnutrition. Left ventricular septal and posterior wall thickness in PEM was also tower than that in controls, and the most significant reduction in left ventricular mass, septal and posterior wall thickness was found in the kwashiorkor group. Cardiac output was reduced in proportion to decrease in body size in the patient group (1.6 ± 0.09 vs 2. ı ± O. ı 8, p<0.05), so that cardiac index was not significantly different in patients and in the controls (5.9 ± 0.2 vs 5.7 ± 0.3, p>0.05). The systol ic fu nction indices !ike ejection fraction, fractional shortening, left ventricu lar end-diastolic and endsystolic volumes were not different in patients and the control group. However, ejection fraction was decreased in patients with third-degree malnutrition compared to control s (0.63 ± 0.02 vs 0.69 ± 0.0 ı , p<0.05). Diastoıic function indices !ike peak E velocity of mitral inflow, peak A velocity, E/A ratio, EVTI/A VTI ratio, isovolumic relaxation time, the deceleration time of peak E velocity were not significantly different in patients from the controls, except decreased acceleration time of mitral inflow to peak E in the patient group (47.2±1.4 vs 54.4±1.4 msec, p<0,05). In conclusion, we demonstrated that left ventricular mass and cardiac output are reduced in proportion to decrease in the body size in patients with PEM, and left ventricular systolic and diastolic functions are preserved in the atrophic hearts, except in thirddegree malnutrition.

Keywords: Protein energy malnutrition, cardiac functions, left ventricular mass


Manuscript Language: Turkish
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