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Cardiac Dysfunction in a Porcine Model of Pediatric Malnutrition.

Fabiansen C, Lykke M, Hother AL, Koch J, Nielsen OB, Hunter I, Goetze JP, Friis H, Thymann T - PLoS ONE (2015)

Bottom Line: However, when release occurred, cardiac troponin-T concentration was 6.9-fold higher (95%CI: 3.0-15.9; p < 0.001) in MAIZE compared to AGE-REF.At week 7, the mean body weight in MAIZE was lower than AGE-REF (8.3 vs 32.4 kg, p < 0.001), whereas heart-weight relative to body-weight was similar across the three groups.The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p < 0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025).

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.

ABSTRACT

Background: Half a million children die annually of severe acute malnutrition and cardiac dysfunction may contribute to the mortality. However, cardiac function remains poorly examined in cases of severe acute malnutrition.

Objective: To determine malnutrition-induced echocardiographic disturbances and longitudinal changes in plasma pro-atrial natriuretic peptide and cardiac troponin-T in a pediatric porcine model.

Methods and results: Five-week old piglets (Duroc-x-Danish Landrace-x-Yorkshire) were fed a nutritionally inadequate maize-flour diet to induce malnutrition (MAIZE, n = 12) or a reference diet (AGE-REF, n = 12) for 7 weeks. Outcomes were compared to a weight-matched reference group (WEIGHT-REF, n = 8). Pro-atrial natriuretic peptide and cardiac troponin-T were measured weekly. Plasma pro-atrial natriuretic peptide decreased in both MAIZE and AGE-REF during the first 3 weeks but increased markedly in MAIZE relative to AGE-REF during week 5-7 (p ≤ 0.001). There was overall no difference in plasma cardiac troponin-T between groups. However, further analysis revealed that release of cardiac troponin-T in plasma was more frequent in AGE-REF compared with MAIZE (OR: 4.8; 95%CI: 1.2-19.7; p = 0.03). However, when release occurred, cardiac troponin-T concentration was 6.9-fold higher (95%CI: 3.0-15.9; p < 0.001) in MAIZE compared to AGE-REF. At week 7, the mean body weight in MAIZE was lower than AGE-REF (8.3 vs 32.4 kg, p < 0.001), whereas heart-weight relative to body-weight was similar across the three groups. The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p < 0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025).

Conclusions: Malnutrition associates with cardiac dysfunction in a pediatric porcine model by increased myocardial performance index and pro-atrial natriuretic peptide and it associates with cardiac injury by elevated cardiac troponin-T. Clinical studies are needed to see if the same applies for children suffering from malnutrition.

No MeSH data available.


Related in: MedlinePlus

Myocardial Performance Index (MPI) derived by color tissue Doppler echocardiography.Top: Apical left 4-chamber view in end-systole showing the position of M-mode line used for measurement of cardiac intervals. Bottom: Colour diagram of the tissue Doppler imaging M-mode of the anterior mitral leaflet. a = interval from mitral valve closing to opening; b = ejection time. Myocardial performance index = (a—b)/ b = 355 ms– 236 ms/236 ms = 0.50.
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pone.0140472.g001: Myocardial Performance Index (MPI) derived by color tissue Doppler echocardiography.Top: Apical left 4-chamber view in end-systole showing the position of M-mode line used for measurement of cardiac intervals. Bottom: Colour diagram of the tissue Doppler imaging M-mode of the anterior mitral leaflet. a = interval from mitral valve closing to opening; b = ejection time. Myocardial performance index = (a—b)/ b = 355 ms– 236 ms/236 ms = 0.50.

Mentions: Tissue Doppler imaging (TDI) was performed with a narrow sector view on the left apical 4-chamber view with a sampling frequency >150 Hz. All measurements were averaged from three consecutive cardiac cycles. TDI-derived MPI was measured with cardiac event timing using curved anatomical m-mode modality, which has a good temporal resolution [34]. A 2 cm line was drawn manually perpendicular through the anterior mitral leaflet. The positions of mitral valve opening and closure together with aortic valve opening were identified on the curved anatomical m-mode (Fig 1), and aorta valve closure was identified as the end of the thin blue line after ejection (end systole) [32,35]. MPI is the sum of isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT), divided by ejection time (ET). TDI-MPI was derived as (a-b)/b, where ‘a’ is the measured duration from mitral-closure-to-opening and ‘b’ is the aortic flow ejection time.


Cardiac Dysfunction in a Porcine Model of Pediatric Malnutrition.

Fabiansen C, Lykke M, Hother AL, Koch J, Nielsen OB, Hunter I, Goetze JP, Friis H, Thymann T - PLoS ONE (2015)

Myocardial Performance Index (MPI) derived by color tissue Doppler echocardiography.Top: Apical left 4-chamber view in end-systole showing the position of M-mode line used for measurement of cardiac intervals. Bottom: Colour diagram of the tissue Doppler imaging M-mode of the anterior mitral leaflet. a = interval from mitral valve closing to opening; b = ejection time. Myocardial performance index = (a—b)/ b = 355 ms– 236 ms/236 ms = 0.50.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608818&req=5

pone.0140472.g001: Myocardial Performance Index (MPI) derived by color tissue Doppler echocardiography.Top: Apical left 4-chamber view in end-systole showing the position of M-mode line used for measurement of cardiac intervals. Bottom: Colour diagram of the tissue Doppler imaging M-mode of the anterior mitral leaflet. a = interval from mitral valve closing to opening; b = ejection time. Myocardial performance index = (a—b)/ b = 355 ms– 236 ms/236 ms = 0.50.
Mentions: Tissue Doppler imaging (TDI) was performed with a narrow sector view on the left apical 4-chamber view with a sampling frequency >150 Hz. All measurements were averaged from three consecutive cardiac cycles. TDI-derived MPI was measured with cardiac event timing using curved anatomical m-mode modality, which has a good temporal resolution [34]. A 2 cm line was drawn manually perpendicular through the anterior mitral leaflet. The positions of mitral valve opening and closure together with aortic valve opening were identified on the curved anatomical m-mode (Fig 1), and aorta valve closure was identified as the end of the thin blue line after ejection (end systole) [32,35]. MPI is the sum of isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT), divided by ejection time (ET). TDI-MPI was derived as (a-b)/b, where ‘a’ is the measured duration from mitral-closure-to-opening and ‘b’ is the aortic flow ejection time.

Bottom Line: However, when release occurred, cardiac troponin-T concentration was 6.9-fold higher (95%CI: 3.0-15.9; p < 0.001) in MAIZE compared to AGE-REF.At week 7, the mean body weight in MAIZE was lower than AGE-REF (8.3 vs 32.4 kg, p < 0.001), whereas heart-weight relative to body-weight was similar across the three groups.The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p < 0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025).

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.

ABSTRACT

Background: Half a million children die annually of severe acute malnutrition and cardiac dysfunction may contribute to the mortality. However, cardiac function remains poorly examined in cases of severe acute malnutrition.

Objective: To determine malnutrition-induced echocardiographic disturbances and longitudinal changes in plasma pro-atrial natriuretic peptide and cardiac troponin-T in a pediatric porcine model.

Methods and results: Five-week old piglets (Duroc-x-Danish Landrace-x-Yorkshire) were fed a nutritionally inadequate maize-flour diet to induce malnutrition (MAIZE, n = 12) or a reference diet (AGE-REF, n = 12) for 7 weeks. Outcomes were compared to a weight-matched reference group (WEIGHT-REF, n = 8). Pro-atrial natriuretic peptide and cardiac troponin-T were measured weekly. Plasma pro-atrial natriuretic peptide decreased in both MAIZE and AGE-REF during the first 3 weeks but increased markedly in MAIZE relative to AGE-REF during week 5-7 (p ≤ 0.001). There was overall no difference in plasma cardiac troponin-T between groups. However, further analysis revealed that release of cardiac troponin-T in plasma was more frequent in AGE-REF compared with MAIZE (OR: 4.8; 95%CI: 1.2-19.7; p = 0.03). However, when release occurred, cardiac troponin-T concentration was 6.9-fold higher (95%CI: 3.0-15.9; p < 0.001) in MAIZE compared to AGE-REF. At week 7, the mean body weight in MAIZE was lower than AGE-REF (8.3 vs 32.4 kg, p < 0.001), whereas heart-weight relative to body-weight was similar across the three groups. The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p < 0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025).

Conclusions: Malnutrition associates with cardiac dysfunction in a pediatric porcine model by increased myocardial performance index and pro-atrial natriuretic peptide and it associates with cardiac injury by elevated cardiac troponin-T. Clinical studies are needed to see if the same applies for children suffering from malnutrition.

No MeSH data available.


Related in: MedlinePlus