Mass and Left Ventricular Function in Protein Energy Malnutrion Marasmic Type

  • Herlina Dimiati Department of Pediatrics, Faculty of Medicine, University of Syiahkuala and Zaenoel Abidin Hospital, Banda Aceh
  • Sudigdo Sastroasmoro Department of Pediatrics, Faculty of Medicine University of Indonesia, and Cipto Mangunkusumo National Hospital, Jakarta
  • Sukman Tulus Putra Department of Pediatrics, Faculty of Medicine University of Indonesia, and Cipto Mangunkusumo National Hospital, Jakarta
  • Aryono Hendarto Department of Pediatrics, Faculty of Medicine University of Indonesia, and Cipto Mangunkusumo National Hospital, Jakarta

Abstract

Objectives. To determine the left ventricular mass, the left ventricular systolic anddiastolic function of children suffering protein energy malnutrion marasmic type.
Material.Pediatric patients suffering protein energy malnutrion marasmic type who came for treatment in Division of Pediatric Metabolic Nutrition, Departement of Child Health, Medical Faculty, Cipto Mangunkusumo Hospital Jakarta between June to August 2007.
Methods. A cross-sectional study was conducted to evaluate left ventricular systolic function (EF and FS), left ventricular diastolic function (E, A, ratio E/A and IVRT) and left ventricular mass (LVDDi, LVDSi, LVMi) by Ultrasonography Sonos 4500. The student t-test was used, statistical significant was assumed with a< 0.05 with program SPSS 15.0 version.
Results. Out of 25 subjects examined (9 male and 16 female), the left ventricular mass in marasmic patients was lower compared to control. Mean of LVMi (g/m2) marasmic and control each 22.5 (SD 17.7) and 39.1 (SD 41.1); p < 0.02. Systolic and diastolic function in marasmic were lower than the control and the difference was statistically significant. Mean EF in marasmic and control each 56.4% (SD 7.2) and 73.2% (SD 7,7) ; p = 0.001. Mean FS 28.6% (SD 4,9) and 40.4% (SD 8.7) ; p = 0.001. Mean ratio E/A in marasmic and control each 1.79 (SD 0.5) and 1.54 (SD 0.2); p = 0.04
Conclusions. The left ventricular mass in marasmic was lower than a child with good nutrition. The left ventricular systolic and diastolic function of marasmic patients were disturbed. The left ventricular diastolic function seen in restrictive pattern.

Downloads

Download data is not yet available.

References

Fioretto JR. Ventricular remodeling and diastolic myocardial dysfunction in rats submitted to protein-calorie malnutrion. Am J Physiol Heart Circ Physiol 282: H1327-H 1333,2002.

Muller O, Krawinkel M. Malnutrition and health in developing countries. CMAJ.Aug. 2,2005; 173(3):279-86.

Ocal B dkk.Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrion. J. Paediatr. Child Health (2001) 37, 14-7.

Fechner A dkk. Antioxidant status and nitric oxide in the mal-nutrion syndrome kwashiorkor. Pediatric Research. Vol. 49, No. 2,2001:237-43.

Suskind D, Murthy KK, Suskind RM. The malnourished child: An overview. Dalam: Suskind RM, Suskind LL, penyunting. The malnourished child. New York: Reven press, 1990.h. 1-22.

Soekirman. Prevention of Protein-Energy Malnutrion through socioeconomic development and community participation.Da-lam: Suskind RM, Suskind LL, penyunting. The mal nourished child. New York: Reven press, 1990.h. 359-70.

Departemen Kesehatan Republik Indonesia Direktorat Jendral Bina Kesehatan Masyarakat Direktorat Gizi Masyarakat. Buku bagan tatalaksana anak gizi buruk. Buku I dan II. 2003.

Waterlow JC. Effects of PEM on structure and functions of organs. Dalam: Protein Energy Malnutrion. Edisi ke- 2. London: Edward Arnold, 1993. h. 54-82.

TalnerNS. Cardiac changes in the malnourished child.Dalam: Suskind RM, Suskind LL, penyunting. The malnourished child. New York: Reven press, 1990.h. 229-44..

WHO. Measuring change in nutritional status.

Gonzalez C dkk. Hydrogen Peroxide – Induced DNA damage and DNA repair in lymphocytes from malnourished children. Environ, Mol, Mutagen. 2002; 39;33 – 42.

Viart P. Hemodynamic findings in severe protein-calorie malnutrion. The American Journal of clinical nutrion 30: March 1977, pp. 334-48.

Phornphatkul C. Cardiac function in Malnourished children. Clinical Pediatrics: March 1994. h. 147-54.

Greaves SC. Assesment of left ventricular systolic function in research and in clinical practice. Heart. 2000;83:493-4.

Cheesman MG, Leech G, Chamber J, Monaghan MJ, Nihoy-annopoulos P. Center role of ehocardiography in the diagnosis and assesment of heart failure. Heart. 1998;80 (supplement 1):S1 – S5.

Fedele F, Trambaiolo P, Magni g, De Castro S, Caccioti L. New modalities of regional and global left ventricular function analysis: state of the art. Am J Cardiol. 1998;81(12A);49G–57G.

Oemar H. Perhitungan hemodinamik. Dalam: Oemar H dkkpenyunting. Textbook of echocardiography interpretasi dan diagnosis klinik. Edisi ke-1. Indonesia: Intermasa, 2005. h. 87 – 116.

Douglas D, Schcken, Holloway D, Power PS. Weigh loss and the heart, effect of anorexia nervosa and starvation. Arch Intern Med ;1989;149;877 – 81.

Mele D, Pedini I, Alboni P, Levine RA. Anatomic m-mode: a new technique for quantitative assesment of left ventricular size and function. Am J Cardiol; 1998;81(12A):82G – 85G.

Oemar H. Diastologi. Dalam: Oemar H dkkpenyunting. Textbook of echocardiography interpretasi dan diagnosis klinik. Edisi ke-1. Indonesia: Intermasa, 2005. h. 193 – 214..

Park MK, Troxler RG. Prymary myocardial disease. Dalam: Park MK, penyunting. Pediatric cardiology for practitioners. Edisi ke-4. St. Louis: Mosby; 2002. h. 267 - 80.
Views & Downloads
Abstract views: 319   
PDF (Bahasa Indonesia) downloads: 155   
How to Cite
Dimiati, H., Sastroasmoro, S., Putra, S., & Hendarto, A. (1). Mass and Left Ventricular Function in Protein Energy Malnutrion Marasmic Type. Indonesian Journal of Cardiology, 32(3), 152-9. https://doi.org/10.30701/ijc.v32i3.91
Section
Clinical Research