[Nutritional status of children with congenital heart disease and left-to-right shunt. The importance of the presence of pulmonary hypertension].
OBJECTIVE
To assess the nutritional status of children with congenital heart disease with left-to-right shunt and the nutritional disturbances related to the presence of pulmonary hypertension (PH).


METHODS
In a prospective study, the nutritional status of 30 children with left-to-right shunt (16 with and 14 without PH) was determined by anthropometric parameters and plasma proteins albumin, transferrin and prealbumin. Frequency and extent of nutritional disturbances were analysed in relation to the presence of PH. A control group of 20 well-nourished children was formed, aiming to compare the values of the serum proteins.


RESULTS
The nutritional classification according to Waterlow's criteria showed an overall prevalence of malnutrition of 83.3%, which was higher in those with PH (p = 0.0140). This patient's group was more wasted than the group without PH (median z score of weight for height -1.65 vs -0.78). There was a high occurrence of measurements of arm fat area below the 5th percentile, which were similar in both groups. Serum levels of albumin and prealbumin were significantly lower in children with congenital heart disease than in the control group and transferrin values were similar in both.


CONCLUSIONS
The prevalence of malnutrition was high. The presence of PH was associated with higher nutritional disturbance. The nutritional assessment may be a good way to identify diagnostic groups at particular risk of failure to thrive. This can be useful in planning a management which ensures these patients to achieve adequate nutritional supplementation in early life.
Leite
H P
HP
Escola Paulista de Medicina-UNIFESP, São Paulo.
de Camargo Carvalho
A C
AC
Fisberg
M
M
D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D015596:Nutrition Assessment; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000150:complications* / Q000209:etiology
O estado nutricional de crianças portadoras de cardiopatia congênita com shunt esquerda-direita. Importância da presença de hipertensão pulmonar.