Impact Of Protein Energy Malnutrition On Heart Structure and function

Malnutrition is a suboptimal (deficient or excessive) supply of nutrients that interferes with an individual´s growth, development, and maintenance of health. Protein energy malnutrition alter cell metabolism, structure , and function progressing to organs and systems affection. The effects of malnutrition on cardiovascular system may be an example. Aims of the study:1.Assess the heart size, structure, and function in malnourished children in comparison with those without malnutrition.2.Estimate the association between anthropometric indicators and cardiac measurements. Methods and Materials: This is a community-based comparative study conducted in Baghdad Aljadida sub district. The sample included 37 malnourished, and 42 normal school children. Clinical examination, biochemical investigation, ECG and echocardiography have been done for the two groups. Results :Results showed significantly lower cardiac measurements for cases than for controls. Inter-ventricular septum thickness during diastole mean (IVSD) was ( 0.5311cm ± 0.0564) for cases, and (0.6771cm ± 0.0825) for controls (p<0.000). Inter-ventricular septum thickness during systole (IVSS) mean was ( 0.8746cm ± 0.10418) for cases, and (0.9848cm ±0.16760 ) for controls (p= 0.001). Mean posterior Left Ventricular wall thickness during diastole (PWD)was (0.5157cm± .05905 ) for cases, and (0.6717cm± 0.08439 ) for controls (p=.000). Posterior wall thickness during systole (PWS) mean was ( 0.7892cm ± .11369) for cases, and (0.9738cm± 0.11605) for controls (p=.000). Mean left ventricular end diastolic dimension (LVEDD) was( 3.559cm ± 0.3700) for cases, and ( 3.864cm± 0.3553), for controls (p=.000 ). Mean left ventricular end diastolic volume (LVEDV) was (54.43ml± 13.422) for cases, and (65.24ml ± 14.498 ) for controls(p=.001).
Mean left ventricular end systolic dimension (LVESD) was (2.211cm± 0.3169) for cases, and (2.431cm±0.2580) for controls (p=.001). Mean left ventricular end systolic volume (LVESV) was (17.41ml±4.924) for cases, and ( 20.95ml ± 5.203) for controls (p= .003). The mean left ventricular stroke volume (LVSV) was (37.62ml ±10.602) for cases, and (44.55ml ± 11.445) for controls (p=.007).
Left Ventricle mass mean values were (44.308gm ± 7.244) for cases , and (71.905gm ±17.953) for controls (p= .000). Cardiac measurements also showed positive linear correlation with anthropometric indicators. Heart mass, inter ventricular-septal thickness(IVSD), posterior left ventricular wall thickness(PW) showed very high correlation with both Height-Age Z score, and Weight-Age Z score.
Conclusion: Heart structure and function is significantly affected among physically active malnourished children.