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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

Comparison of Myocardial performance index (MPI), Isovolumic relaxation time (IVRT) Isovolumic contraction time (IRCT) and Ejection time (ET) (means ± SEM).Measurements from individual pigs: MAIZE (n = 8), AGE-REF (n = 8), WEIGHT-REF (n = 8). a,b,cMeans not sharing a letter in their superscript are significantly different (p<0.05).
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pone.0140472.g002: Comparison of Myocardial performance index (MPI), Isovolumic relaxation time (IVRT) Isovolumic contraction time (IRCT) and Ejection time (ET) (means ± SEM).Measurements from individual pigs: MAIZE (n = 8), AGE-REF (n = 8), WEIGHT-REF (n = 8). a,b,cMeans not sharing a letter in their superscript are significantly different (p<0.05).

Mentions: TDI-derived MPI was 86% higher in MAIZE than AGE-REF (0.59 vs. 0.32, p<0.001) and 27% higher than WEIGHT-REF (0.59 vs. 0.46, p = 0.025). Also MPI was 46% higher in WEIGHT-REF than AGE-REF (0.46 vs. 0.32, p = 0.001). There were negative associations between heart rate and MPI and its components (MPI, r2 = 0.42; IVCT, r2 = 0.34; IVRT, r2 = 0.64; ET, r2 = 0.46, all p<0.003, Fig 2). No changes in systolic indices, i.e. fractional shortening and ejection fraction, were observed between the groups. Left ventricular dimensions, wall thickness, peak aorta flow and mitral inflow velocities were lower in MAIZE relative to AGE-REF, but not to WEIGHT-REF (Table 3). Mitral regurgitation was more frequent in MAIZE (MAIZE 7/8, AGE-REF 3/8, WEIGHT-REF 2/8, p = 0.03), four MAIZE pigs had severe MR (RF>50%) while all remaining MR were trivial-to-mild (mean jet area/LA ratio = 22%). All MR velocities were approximately 5 m/s. Tricuspid regurgitation (TR) was similar between groups (MAIZE 7/8, AGE-REF 5/8, WEIGHT-REF 7/8, p = 0.36). All TR velocities were <2.5 m/s.


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)

Comparison of Myocardial performance index (MPI), Isovolumic relaxation time (IVRT) Isovolumic contraction time (IRCT) and Ejection time (ET) (means ± SEM).Measurements from individual pigs: MAIZE (n = 8), AGE-REF (n = 8), WEIGHT-REF (n = 8). a,b,cMeans not sharing a letter in their superscript are significantly different (p<0.05).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0140472.g002: Comparison of Myocardial performance index (MPI), Isovolumic relaxation time (IVRT) Isovolumic contraction time (IRCT) and Ejection time (ET) (means ± SEM).Measurements from individual pigs: MAIZE (n = 8), AGE-REF (n = 8), WEIGHT-REF (n = 8). a,b,cMeans not sharing a letter in their superscript are significantly different (p<0.05).
Mentions: TDI-derived MPI was 86% higher in MAIZE than AGE-REF (0.59 vs. 0.32, p<0.001) and 27% higher than WEIGHT-REF (0.59 vs. 0.46, p = 0.025). Also MPI was 46% higher in WEIGHT-REF than AGE-REF (0.46 vs. 0.32, p = 0.001). There were negative associations between heart rate and MPI and its components (MPI, r2 = 0.42; IVCT, r2 = 0.34; IVRT, r2 = 0.64; ET, r2 = 0.46, all p<0.003, Fig 2). No changes in systolic indices, i.e. fractional shortening and ejection fraction, were observed between the groups. Left ventricular dimensions, wall thickness, peak aorta flow and mitral inflow velocities were lower in MAIZE relative to AGE-REF, but not to WEIGHT-REF (Table 3). Mitral regurgitation was more frequent in MAIZE (MAIZE 7/8, AGE-REF 3/8, WEIGHT-REF 2/8, p = 0.03), four MAIZE pigs had severe MR (RF>50%) while all remaining MR were trivial-to-mild (mean jet area/LA ratio = 22%). All MR velocities were approximately 5 m/s. Tricuspid regurgitation (TR) was similar between groups (MAIZE 7/8, AGE-REF 5/8, WEIGHT-REF 7/8, p = 0.36). All TR velocities were <2.5 m/s.

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