Muscle force and power in obese and overweight children.

The study investigated differences in skeletal muscle function between obese and non-obese children using a force platform. Forty obese children and adolescents (age range 8 to 18 years; 21 girls) and 40 age- and sex-matched controls performed two tests: (1) single two-legged jump, a countermovement jump for maximal height; (2) multiple one-legged hopping on the forefoot, a test of maximal force. In the single two-legged jump, obese subjects had higher absolute peak force (1.62 kN vs 1.09 kN) and peak power (2.46 kW vs 2.06 kW), but lower body weight-related peak force (2.10 vs 2.33) and lower peak power per body mass (30.9 W/kg vs 41.6 W/kg). Jump height (29.3 cm vs 37.5 cm) and maximal vertical velocity (1.92 ms(-1) vs 2.31 ms(-1)) were reduced in obese children. In multiple one-legged hopping, obese subjects had 72% and 84% higher absolute peak force on the left and right foot, respectively. However, forces relative to body weight were 24% and 23% lower in the obese group than in the control group. In conclusion, obese children and adolescents have increased muscle force and power. This partly compensates for the effect of high body weight on muscle performance.

NT-Pro-B-Type Natriuretic Peptide Levels in Infants with Failure to Thrive due to Caloric Deprivation.

Background. Brain natriuretic peptide and its inactive fragment N-terminal pro-BNP (N-BNP) are reliable markers of ventricular dysfunction in adults and children. We analyzed the impact of nutritional state on N-BNP levels in infants with failure to thrive (FTT) and in infants with severe heart failure (HF). The purpose of this study was to compare N-BNP levels in infants with FTT with infants with severe HF and healthy controls. Methods. In a retrospective cohort study, we compared N-BNP levels from all consecutive infants with FTT and bodyweight below the tenth percentile (caloric deprivation (CD) group) to infants with severe HF. Reference values from infants between 2 and 12 month were taken from the literature and healthy infants. Results. Our results show that infants with FTT (n = 15) had significantly (P < .001) elevated N-BNP values compared with the healthy infants (n = 23), 530 (119-3150) pg/mL versus 115 (15-1121) pg/mL. N-BNP values in this CD group are comparable to the median value of infants with severe HF (n = 12) 673 (408-11310) pg/mL. There is no statistical significant difference in age. Conclusion. Nutritional state has an important impact on N-BNP levels in infants with FTT. We could show comparable levels of N-BNP in infants with FTT and infants with severe HF.

Electrical velocimetry for measuring cardiac output in children with congenital heart disease.

BACKGROUND: The purpose of this study was to evaluate the agreement of cardiac output measurements obtained by electrical velocimetry (CO(EV)) and those that derived from the direct Fick-oxygen principle (CO(F)) in infants and children with congenital heart defects. METHODS: Simultaneous measurements of CO(EV) and CO(F) were compared in 32 paediatric patients, aged 11 days to 17.8 yr, undergoing diagnostic right and left heart catheterization. For non-invasive measurements of cardiac output by electrical velocimetry, which is a variation of impedance cardiography, standard surface electrodes were applied to the left side of the neck and the left side of the thorax at the level of the xiphoid process. Cardiac output determined using direct Fick-oxygen principle was calculated by direct measurement of oxygen consumption (VO2) and invasive determination of the arterio-venous oxygen content difference. RESULTS: An excellent correlation (r=0.97) was found between CO(EV) and CO(F) (P<0.001). The slope of the regression equation [0.96 (SD 0.04)] was not significantly different from the line of identity. The bias between the two methods (CO(EV)-CO(F)) was 0.01 litre min(-1) and the limits of agreement, defined as the bias (2 SD), were -0.47 and +0.45 litre min(-1). CONCLUSIONS: CO(EV) demonstrates acceptable agreement with data derived from CO(F) in infants and children with congenital heart disease. The new technique is simple, completely non-invasive, and provides beat-to-beat estimation of CO.

[The technique of outflow tract reconstruction in patients with tetralogy of Fallot influence the morbidity 3 decades after repair]. / Die Technik der Ausflussbahnrekonstruktion bei Fallotscher Tetralogie beeinflusst die Morbidität der Patienten nach drei Jahrzehnte nach einer Korrekturoperation.

The purpose of this study was to examine long-term results of different surgical techniques in patients with tetralogy of Fallot considering their morbidity. We analyzed the data of 74 patients 24.5 +/- 3 years after surgical repair in childhood to evaluate their clinical status, maximal exercise capacity, medication and frequency of reoperations. We compared two groups of patients according to the surgical techniques employed: 1) TAP group (Trans anular Patch, n = 41) in which ventricular septal defects were closed with a Dacron patch, the right ventricular outflow was reconstructed by resection of the partial extension of the infundibular septum and transanular patch repair was performed because of hypoplastic pulmonary valve. 2) nonTAP group (33) in which no transanular patch repair was necessary. Most of the patients described their health as "good". 94% of the nonTAP group and 71% of TAP group were in NYHA class I. The rest were in NYHA class II. Despite the good clinical classification we found a reduced cardiopulmonary exercise capacity in all patients. More than 50% in the TAP group took medicine because of congestive heart failure and/or arrhythmia, which was present 3-times more often compared with the nonTAP group. Furthermore, 50% of TAP group patients had at least one reoperation during the follow- up: by comparison 5-times more often than the nonTAP group. These data show that the long-term outcome and morbidity of the patients after repair is closely related to the type of the surgical technique employed.