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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 temporal changes in plasma proANP, creatinine and urea (means ± SEM).Weekly measurements from pig groups: MAIZE (n = 12), AGE-REF (n = 12). Differences in means *(p<0.05), ** (p<0.01), *** (p<0.001).
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pone.0140472.g004: Comparison of temporal changes in plasma proANP, creatinine and urea (means ± SEM).Weekly measurements from pig groups: MAIZE (n = 12), AGE-REF (n = 12). Differences in means *(p<0.05), ** (p<0.01), *** (p<0.001).

Mentions: Plasma proANP decreased during the first 3 weeks for both MAIZE and AGE-REF, followed by a marked increase in MAIZE relative to AGE-REF during weeks 5–7 (Fig 4, Panel A, p≤0.001). Moreover, there was a positive association between MPI and proANP at the time of killing (r2 = 0.34, p = 0.017). As circulating proANP may be influenced by kidney function, we measured creatinine and urea and found no consistent differences between MAIZE and AGE-REF (Fig 4, Panels B and C).There was overall no difference in cTnT between groups. Release of cTnT in plasma was more frequent in AGE-REF than MAIZE (OR: 4.8; 95%CI: 1.2–19.7; p = 0.03). However, when release occurred, cTnT concentration was 6.9-fold higher (95%CI: 3.0–15.9; p<0.001) in MAIZE (Fig 5). Finally, electrolytes and hemoglobin declined progressively in MAIZE relative to AGE-REF (Fig 6). Serum albumin followed a similar pattern, with markedly lower levels in MAIZE vs AGE-REF at week 7 (20.7±0.7 g/L vs. 35.6±0.7 g/L, p<0.001).


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 temporal changes in plasma proANP, creatinine and urea (means ± SEM).Weekly measurements from pig groups: MAIZE (n = 12), AGE-REF (n = 12). Differences in means *(p<0.05), ** (p<0.01), *** (p<0.001).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0140472.g004: Comparison of temporal changes in plasma proANP, creatinine and urea (means ± SEM).Weekly measurements from pig groups: MAIZE (n = 12), AGE-REF (n = 12). Differences in means *(p<0.05), ** (p<0.01), *** (p<0.001).
Mentions: Plasma proANP decreased during the first 3 weeks for both MAIZE and AGE-REF, followed by a marked increase in MAIZE relative to AGE-REF during weeks 5–7 (Fig 4, Panel A, p≤0.001). Moreover, there was a positive association between MPI and proANP at the time of killing (r2 = 0.34, p = 0.017). As circulating proANP may be influenced by kidney function, we measured creatinine and urea and found no consistent differences between MAIZE and AGE-REF (Fig 4, Panels B and C).There was overall no difference in cTnT between groups. Release of cTnT in plasma was more frequent in AGE-REF than MAIZE (OR: 4.8; 95%CI: 1.2–19.7; p = 0.03). However, when release occurred, cTnT concentration was 6.9-fold higher (95%CI: 3.0–15.9; p<0.001) in MAIZE (Fig 5). Finally, electrolytes and hemoglobin declined progressively in MAIZE relative to AGE-REF (Fig 6). Serum albumin followed a similar pattern, with markedly lower levels in MAIZE vs AGE-REF at week 7 (20.7±0.7 g/L vs. 35.6±0.7 g/L, p<0.001).

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