title: Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition.
abstract: OBJECTIVE
  This study was undertaken to assess the left ventricular mass (LV Mass) and systolic and diastolic functions of the left ventricle in children with protein energy malnutrition (PEM).
  
  
  METHODS
  Thirty children, aged between 2 months and 2 years with PEM (four kwashiorkor, seven marasmic- kwashiorkor, 19 marasmus), and 17 healthy, age-matched children, using Doppler echocardiography were studied.
  
  
  RESULTS
  The mean LV Mass in the patients was lower than that in the controls (14.5 +/- 5.2 vs 19.8 +/- 4.7 g, P < 0.05). However, the LV Mass/body surface area was not different in the patients with PEM and in the control group (52 +/- 9.2 vs 53.9 +/- 8.2g/m(2), P > 0.05), indicating that LV Mass was reduced in proportion to decrease in body size in malnutrition. Left ventricular septal and posterior wall thickness in PEM were also lower than that in the controls, and the most significant reduction in the LV Mass, septal and posterior wall thickness were found in the kwashiorkor group. Cardiac 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 subjects (5.9 +/- 1.4 vs 5.7 +/- 1.6 L/min/m(2), P > 0.05). Systolic function indices including ejection fraction, fractional shortening, and diastolic function indices were not significantly different in the groups.
  
  
  CONCLUSIONS
  We demonstrated that LV Mass and cardiac output were reduced in proportion to decrease in body size in patients with PEM, and LV systolic and diastolic functions were preserved in atrophic hearts.
authors.affiliation: Department of Pediatric Cardiology, Dr Sami Ulus Children's Hospital, Ankara, Turkey. burhan.ocal@isbank.net.tr
authors.forename: B
authors.initials: B
authors.lastname: Ocal
authors.forename: S
authors.initials: S
authors.lastname: Unal
authors.forename: P
authors.initials: P
authors.lastname: Zorlu
authors.forename: H T
authors.initials: HT
authors.lastname: Tezic
authors.forename: D
authors.initials: D
authors.lastname: Oğuz
mesh_terms: D001794:Blood Pressure; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000150:complications* / Q000503:physiopathology; D007732:Kwashiorkor / Q000150:complications; D008297:Male; D011502:Protein-Energy Malnutrition / Q000150:complications* / Q000503:physiopathology; D018709:Statistics, Nonparametric; D014421:Turkey / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology