Comparative echocardiographic analysis of Cardiac function and left ventricular mass among Children admitted with severe acute malnutrition In jimma university specialized hospital, 2013.

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