Evaluation of the cardiac functions in malnourished patients between one month and eighteen years

ABSTRACTEVALUATION OF THE CARDIAC FUNCTIONS IN MALNOURISHED PATIENTS BETWEEN ONE MONTH AND EIGHTEEN YEARSMalnourished children suffer several alterations in body composition that could produce cardiac abnormalities as hypotension, cardiac arrhythmias, myocardiopathy, cardiac failure and sudden death. The objective of this study is to compare biochemical, electrocardiographic and echocardiographic parameters between a group of malnourished children and a control group of the same age.The study grup consisted of 47 malnourished infants and young children (27 female and 20 male) and 44 healty kontrols (25 female and 19 male). All the malnourished and healty childeren were subjekted to elektrocardiographic, ecocardiographic and biochemical evaluation.The average ages of 47 children with malnourished and 44 healty childeren were respectively 69,4 and 68,9 months. Malnourished childeren showed a significantly lower left ventriküler mass than the control group (42,3±24,5 gr vs 53,4±23,9 gr, p<0,05). However, the LVMİ was not different in the patients with malnoutrished and in the control group (60,7±13,3 vs 61,9±12,1, p>0,05). Indicating that LV mass was reduced in proportion to decrease in body size in malnutrition. Cardiac output was lower in the severe malnoutrished group than in the kontrol group (1,7±1,3 vs 3.1±1,1 L/min, p<0,05), however cardiac index was not significantly different between the patients and the control groups (2,6±1,1 vs 3,1±1,1 p>0,05). The LV systolic functions were significantly impaired in patients with malnütrition. Systolic function indices including ejection fraction and fractional shortening were lower in patients than kontrol group (EF: 66,2±5,3 vs 69,2±4,07 p<0,05; FS: 35,4±4,2 vs 37,9±3,4, p<0,05). Combined systolik and diastolic functions indices including MPİ was higher in patients than kontrols (0,45±0,09 vs 0,36±0,05 p<0,01). The ımpairments in cardiac functions were corelated the severity and duration of malnutrition. The level of troponin wasnt high in any patient.Dispersiyon of the QTc (QTcD) and QTD were significantly greater in patients with malnutrition than in controls (QTcD: 47,9±16,8 vs 32,9±10,6, p<0,001; QTD: 21,5±9,2 vs 28,2±9,2, p<0,01) and this increase was correlated the severity and duration of malnutrition. However we did not find compleks ventricular aritmi in any patient.As a result ımportant electrocardiographic and echocardiographic abnormalities have been found in malnourished children associated with their nutritional status. Cardiac evaluation and early nutrition therapy must be taken into account in the management of these patients.Key words: Malnutrition, Children, Cardiac functions