Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition

Objective: This study was undertaken to assess the left ventricular mass (L V Mass) and systolic and diastolic functions of the left ventricle in child ren with protein energy malnutrition (PEM). Methodology: Thirty children, aged between 2 months and 2 years with PEM (f our kwashiorkor, seven marasmickwashiorkor, 19 marasmus), and 17 healthy, a ge-matched children, using Doppler echocardiography were studied. Results: The mean LV Mass in the patients was lower than that in the contro ls (14.5 +/- 5.2 vs 19.8 +/- 4.7 g, P < 0.05). However, the LV Mass/body su rface area was not different in the patients with PEM and in the control gr oup (52 +/- 9.2 vs 53.9 +/- 8.2g/m(2), P > 0.05), indicating that LV Mass w as reduced in proportion to decrease in body size in malnutrition. Left ven tricular septal and posterior wall thickness in PEM were also lower than th at in the controls, and the most significant reduction in the LV Mass, sept al and posterior wall thickness were found in the kwashiorkor group. Cardia c output was reduced in proportion to decrease in body size in the patient group (1.6 +/- 0.5 vs 2.1 +/- 0.8 L/min, P < 0.05), therefore cardiac index was not significantly different between the patients and the control subje cts (5.9 +/- 1.4 vs 5.7 +/- 1.6 L/min/m(2), P > 0.05). Systolic function in dices including ejection fraction, fractional shortening, and diastolic fun ction indices were not significantly different in the groups. Conclusions: We demonstrated that LV Mass and cardiac output were reduced i n proportion to decrease in body size in patients with PEM, and LV systolic and diastolic functions were preserved in atrophic hearts.