El Razaky Osama, Naeem Ahmed, Donia Amr, El Amrousy Doaa, Elfeky Noha
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Echocardiography. 2017 Nov;34(11):1674-1679. doi: 10.1111/echo.13692. Epub 2017 Sep 12.
To evaluate electrocardiographic and echocardiographic changes in moderately malnourished children and to correlate them with both anthropometric and electrolyte changes.
Sixty moderately malnourished children were taken as patient group, and 60 healthy children of matched age and sex were taken as control group. Weight, height, body mass index (BMI), serum albumin, and electrolytes were measured for all children. Electrocardiographic evaluation for calculated QT (QTc) and QT dispersion (QTd) was performed. Left ventricular (LV) function was also evaluated using conventional echocardiography, tissue Doppler, and strain methods. Left ventricular mass index (LVMI) was also calculated.
Weight, BMI, serum levels of albumin, total calcium, and ionized calcium were significantly lower, while QTc and QTd were significantly prolonged in malnourished children (P = .001 for all). There was significant reduction in LV fraction shortening (FS), LV E'/A', LV strain (S), LV myocardial performance index (MPI), LV global systolic strain (GLSS), and LVMI (P = .001 for all) in malnourished children. There was significant correlation between BMI and all cardiac variables. Moreover, there was significant positive correlation between serum albumin level and LV E'/A' (P = .02), LV GLSS (P = .03), and LVMI (P = .03).Total and ionized calcium level were significantly correlated with QTc, QTd, and LVMI (P < .05 for all). BMI was the most powerful predictor of these electrocardiographic and echocardiographic changes.
Cardiac changes were present in moderately malnourished children as documented by electrocardiographic and echocardiographic changes, and these changes are in strong association with BMI and for a lesser extent with electrolyte changes especially serum calcium.
评估中度营养不良儿童的心电图和超声心动图变化，并将其与人体测量学和电解质变化相关联。
选取60名中度营养不良儿童作为患者组，选取60名年龄和性别匹配的健康儿童作为对照组。测量所有儿童的体重、身高、体重指数（BMI）、血清白蛋白和电解质。进行心电图评估以计算校正QT（QTc）和QT离散度（QTd）。还使用传统超声心动图、组织多普勒和应变方法评估左心室（LV）功能。计算左心室质量指数（LVMI）。
营养不良儿童的体重、BMI、血清白蛋白、总钙和离子钙水平显著降低，而QTc和QTd显著延长（所有P值均为0.001）。营养不良儿童的左心室缩短分数（FS）、左心室E/A'、左心室应变（S）、左心室心肌性能指数（MPI）、左心室整体收缩应变（GLSS）和LVMI均显著降低（所有P值均为0.001）。BMI与所有心脏变量之间存在显著相关性。此外，血清白蛋白水平与左心室E/A'（P = 0.02）、左心室GLSS（P = 0.03）和LVMI（P = 0.03）之间存在显著正相关。总钙和离子钙水平与QTc、QTd和LVMI显著相关（所有P < 0.05）。BMI是这些心电图和超声心动图变化的最有力预测指标。
中度营养不良儿童存在心脏变化，心电图和超声心动图变化证明了这一点，这些变化与BMI密切相关，在较小程度上与电解质变化尤其是血清钙相关。
