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Journal of the American College of Nutrition, Vol. 24, No. 1, 38-43 (2005)
Published by the American College of Nutrition

Electrocardiographic and Echocardiographic Findings in Malnourished Children

José L. Olivares, MD, PhD, Margarita Vázquez, MD, Gerardo Rodríguez, MD, Pilar Samper, MD and Jesús Fleta, MD, PhD

Department of Paediatrics, "Lozano Blesa" Hospital, University of Zaragoza School of Medicine, Zaragoza, SPAIN

Address reprint requests to: Prof. José L. Olivares, MD, PhD, Departamento de Pediatrá, Facultad de Medicina, Universidad de Zaragoza, C/. Domingo Miral s/n, 50009—Zaragoza, SPAIN. E-mail: olivares{at}unizar.es

Objective: To compare heart abnormalities in a group of malnourished children with a control group and to describe their predictive variables.

Methods: Thirty children with malnutrition were matched with thirty healthy children. Anthropometry, plasma levels of albumin and electrolytes were determined. Among others, corrected QT interval (QTc) and QT dispersion (QTd: difference between the maximum and the minimum QT) were measured in 12-lead electrocardiogram; and left ventricular mass (LVm) and left ventricular mass index (LVmi) were measured by echocardiography. Regression analyses were performed with cardiac findings as dependent variables and anthropometric and biochemical data as independent variables.

Results: Plasma levels of albumin, potassium and calcium were lower in malnourished children. QTc and QTd were significantly greater in patients with malnutrition than in controls (QTc: 445.9 ± 31.4 vs. 400.9 ± 17.7 ms, p = 0.000; QTd: 76.4 ± 34.1 vs. 47.9 ± 10.2 ms, p = 0.000). LVm and LVmi were significantly lower in malnourished children (LVm: 55.3 ± 10.3 vs. 71.4 ± 6.9 g, p = 0.000; LVmi: 46.5 ± 6.6 vs. 60.5 ± 4.9 g/m2, p = 0.000). The body mass index (kg/m2) was the most powerful predictor of the variability in QTc (39.1%), LVm (48.1%) and LVmi (51.2%).

Conclusions: Important electrocardiographic and echocardiographic abnormalities have been found in malnourished children associated with their nutritional status. Special precaution must be taken about the possibility of occurrence of arrhythmias and sudden death related with malnutrition.

Key words: malnutrition, QT interval, QT interval dispersion, arrhythmia, left ventricular dimension






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