Abstract:
Introduction: Malnutrition is one of the leading problems in developing countries with basic
stance for majority of common childhood problems. The clinical forms that are prominent and
are associated with mortality are the severe forms of acute malnutrition (edematous or nonedematous). Malnutrition affects every organ system. One of the most important organs
involved- cardiac muscle was studied in this paper. The objective of this study was to compare
the degree of cardiac muscle involvement among severely malnourished children in contrast
with age and sex matched anthropometrically normal controls. It will be used as a baseline data
for further detailed study in addition to its impact in the management of children with severe
acute malnutrition by detailing cardiac function.
Methods and patients: The study was a cross sectional comparative case control study among
thirty children with severe acute malnutrition and age-sex matched fifteen control groups in
JUSH pediatrics department from January to July 2013. Convenient selection of cases and
controls with clearing of exclusion criteria was used after written consent was taken to select
the legible 30 children who were not having any of the exclusion criteria seated. Fifteen children
were selected as controls with anthropometric measures between ±2SD. Each child had
undergone basic clinical examination (general examination, cardiorespiratory, integumentary
and anthropometric measurement and interpretation) and echocardiographic assessment of LV
mass, dimensions and systolic functions. Blood sample was taken for baseline investigation on
hemoglobin/hematocrit. Results were expressed as means ± standard error of means and considered
statistically significant if p < 0.05. Student t-test was used for comparison of means and standards using
web based software “GraphPad calcs”. SPSS®, EpiData, WHO Anthro were used in accordance.
Results: The mean ages for the cases were 2.4±1.7 years and for the control group was 3.3±1.8
years with males took 53.3% comparably in both groups. It was found that Left ventricular
posterior free wall thickness and LV mass were reduced significantly in the group with SAM (P =
0.0001) whereas LVMi and systolic functions (Ejection Fraction and Fractional Shortening) were
not found to be statistically significant. The lowest mean value for EF and FS was on the
edematous SAM children.
Conclusion and Recommendation: This study has revealed that there was cardiac atrophy
without significant systolic functional impairment. I recommend that we need to have a more
detailed study with biochemical markers being integrated and severely malnourished children
being followed prospectively for the chang
