ABSTRACT
Echocardiography (ECHO), electrocardiography (ECG), and chest radiography (CXR) were performed in 44 children with kwashiorkor, and 44 age- and sex-matched controls. In patients with kwashiorkor, mean values obtained for end diastolic dimension (29.2 +/- 3.8 mm), end systolic dimension (20.9 +/- 2.8 mm), posterior ventricular wall thickness (5.42 +/- 0.57 mm), and shortening fraction (28.2 +/- 4.3%) were significantly smaller than the corresponding values obtained in the controls -38.0 +/- 5.8 mm (P < 0.001), 27.6 +/- 4.5 mm (P < 0.001), 7.07 +/- 0.71 mm (P < 0.001) and 31.4 +/- 4.5% (P < 0.05), respectively. Similarly, mean cardiothoracic ratio (48.6 +/- 3.4%) and QRS amplitude (13.20 +/- 4.85 mm) were significantly (P < 0.001) smaller in subjects than controls, corresponding values being 54 +/- 3.2 per cent and 20.18 +/- 5.12 mm, respectively. In the subjects, there was very good correlation between posterior ventricular wall thickness and cardiothoracic ratio (r = 0.93; P < 0.001) and also between the estimated left ventricular mass and S1 + R6 amplitude (r = 0.89; P < 0.001).
Subject(s)
Cardiomyopathies/diagnostic imaging , Kwashiorkor/diagnostic imaging , Cardiomyopathies/complications , Cardiomyopathies/epidemiology , Case-Control Studies , Child, Preschool , Echocardiography , Female , Humans , Infant , Kwashiorkor/complications , Kwashiorkor/epidemiology , Male , Nigeria/epidemiology , Regression AnalysisABSTRACT
An electrocardiogram (ECG), serum electrolytes, serum albumin, haematocrit and cardiothoracic ratio were recorded in 90 Nigerian children with kwashiorkor and 90 age- and sex-matched controls. The ECG abnormalities observed among the study group included sinus tachycardia (91%), low QRS amplitude (100%) and prolonged QTc intervals (17%). Other ECG abnormalities noted were short QTc intervals (three children), prolonged PR intervals (four children) and right axis deviation (two children). The mean serum sodium, potassium, calcium, albumin, haematocrit and cardiothoracic ratio were significantly lower in children with kwashiorkor than in the controls (p < 0.001). The correlation between the QRS amplitude and serum potassium and calcium was poor (p > 0.05). Also, there was poor correlation between heart rate and haematocrit (p > 0.05) and between QTc intervals and serum calcium and potassium (p > 0.05). However, the correlation between the QRS amplitude and cardiothoracic ratio was good (r = 0.91, p < 0.001). These findings suggest that the ECG changes in kwashiorkor are due to myocardial atrophy.
Subject(s)
Arrhythmias, Cardiac/physiopathology , Electrocardiography , Kwashiorkor/physiopathology , Calcium/blood , Cardiac Volume/physiology , Child, Preschool , Female , Heart Conduction System/physiopathology , Hematocrit , Humans , Infant , Long QT Syndrome/physiopathology , Male , Nigeria , Potassium/blood , Serum Albumin/metabolism , Sodium/bloodABSTRACT
Electrocardiograms (ECGs) were performed on 52 children with kwashiorkor and 52 age-and sex-matched controls. Heart rates were higher (p0.05) and QTc intervals longer (p0.05) in patients with kwashiorkor than in the controls. The QRS amplitude in all the leads in patients with kwashiorkor was smaller (p0.05) than those of the controls. The QRS amplitudes in the survivors were significantly wider (p0.05) controls. The QRS amplitudes in the survivors were significantly wider (p0.05) than in those of the patients who died. Average QRS amplitude of less than 5mm in the standard limb leads and less than 10mm in the chest leads indicated poor prognosis
