What affect heart in SAM: structure or function

Ashutosh Kumar Sharma; Ajay Gaur; Neetu Sharma Agrawal

doi:10.18203/2349-3291.ijcp20173171

Authors

Ashutosh Kumar Sharma Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
Ajay Gaur Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
Neetu Sharma Agrawal Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20173171

Keywords:

Ejection fraction, Fraction shortening, Interventricular septum, Left ventricular end diastolic diameter, Mid upper arm circumference, Posterior left ventricular wall thickness

Abstract

Background: Objective of present study was to assess structural and functional cardiac changes in children with severe acute malnutrition between the age of 6 month to 59 months. Setting: The study conducted in Department of paediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior. A prospective case control study. Participants: 100 cases and 100 controls enrolled based on the selection criteria, Control group was selected from patient came in Out Patient Department. Children from 6 months to 59 months of age with weight for height ranging <-3SD and/or Mid Upper Arm Circumference (MUAC) <11.5 cm and/or edematous malnutrition and/or visible severe wasting). Selection of cases and control were done through random sampling method.

Methods: All enrolled admitted children were stabilised after admission as per WHO protocol of management. After that they undergone echocardiographic and electrocardiographic evaluation and data were collected and Analysed.

Results: In this study, study group show decrease in dimension of heart i.e. IVSd (p-value-0.02413), LVEDd (p-value-0.0000017), PLVWd (p-value-0.01493), LVEDs (p-value-0.0000263), PLVWs (p-value-0.0000254) more affected during diastole than systole, increased HR (p-value-0.0044), shorten PR intervals (p-value-0.0001) and shorten P wave(p-value-0.000385), QT (p-value-0.044) and QTc (p-value-0.00968) as compared to control group. Pericardial effusion found in 16 cases in study group (8 mild and 8 trace).

Conclusions: Early evaluation of cardiac function in malnourished child will significantly affect the management of Severe Acute Malnutrition to prevent deaths from Severe Acute Malnutrition.

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