title: Myocardial dysfunction in malnourished children.
abstract: BACKGROUND
  Malnourished children suffer several alterations in body composition that could produce cardiac abnormalities.
  
  
  OBJECTIVE
  The aim of the present study was to detect the frequency of myocardial damage in malnourished children as shown by echocardiography and cardiac troponin T (cTnT) level.
  
  
  METHODS
  Forty-five malnourished infants and young children (mean±SD of age was 11.24 ±7.88 months) were matched with 25 apparently healthy controls (mean±SD of age was 10.78±6.29 months). Blood sample was taken for complete blood picture, liver and kidney function tests, serum sodium, potassium, calcium levels and cTnT. All the malnourished children were subjected to echocardiographic evaluation.
  
  
  RESULTS
  Malnourished children showed a significantly lower left ventricular (LV) mass than the control group. The LV systolic functions were significantly impaired in patients with severe malnutrition. The cTnT level was higher than the upper reference limits in 11 (24.44%) of the studied malnourished children and all of them had a severe degree of malnutrition. The cTnT level was significantly higher in patients with anemia, sepsis and electrolyte abnormalities and it correlated negatively with LV ejection fraction (EF). Six of the studied children with high cTnT levels (54.5%) died within 21 days of treatment while only one case (2.9%) with normal level of cTnT died within the same period.
  
  
  CONCLUSIONS
  LV mass is reduced in malnourished children. Children with severe malnutrition have a significant decrease in LV systolic functions. Elevated cTnT levels in malnourished children has both diagnostic and prognostic significance for cardiomyocyte damage.
authors.affiliation: Department of Pediatrics, Egypt.
authors.forename: Nagla Hassan Abu
authors.initials: NH
authors.lastname: Faddan
authors.forename: Khalid Ibrahim El
authors.initials: KI
authors.lastname: Sayh
authors.forename: Hamdy
authors.initials: H
authors.lastname: Shams
authors.forename: Hosni
authors.initials: H
authors.lastname: Badrawy