Thiamine deficiency and cardiac dysfunction in cambodian infants

Samuel G. Porter, Debra Coats, Philip R. Fischer, Kevanna Ou, Elizabeth L. Frank, Phivan Sreang, Soksan Saing, Mark Topazian, Felicity T Enders, Allison K. Cabalka

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives To compare blood thiamine concentrations, echocardiography findings, and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in infants with clinically diagnosed beriberi and healthy matched controls, and to evaluate changes after thiamine treatment. Study design Sixty-two Cambodian infants (20 cases and 42 controls), aged 2-47 weeks, were enrolled in this prospective study. Echocardiography and phlebotomy were performed at baseline and after thiamine treatment. Results Both cases and controls were thiamine-deficient, with median blood thiamine diphosphate (TDP) concentrations of 47.6 and 55.1 nmol/L, respectively (P =.23). All subjects had normal left ventricular ejection fraction. The median NT-proBNP concentration in cases (340 pg/mL [40.1 pmol/L]) was higher than previously reported normal ranges, but not statistically significantly different from that in controls (175 pg/mL [20.7 pmol/L]) (P =.10), and was not correlated with TDP concentration (P =.13). Two cases with the lowest baseline TDP concentrations (24 and 21 nmol/L) had right ventricular enlargement and elevated NT-proBNP levels that improved dramatically by 48 hours after thiamine administration. Conclusion Only a minority of thiamine-deficient Cambodian infants demonstrate abnormal echocardiography findings. Thiamine deficiency produces echocardiographic evidence of right ventricular dysfunction, but this evidence is not apparent until deficiency is severe. NT-proBNP concentrations are mildly elevated in sick infants with normal echocardiography findings, indicating possible physiological changes not yet associated with echocardiographic abnormalities.

Original languageEnglish (US)
Pages (from-to)1456-1461
Number of pages6
JournalJournal of Pediatrics
Volume164
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Thiamine Deficiency
Thiamine
Brain Natriuretic Peptide
Thiamine Pyrophosphate
Echocardiography
Beriberi
Right Ventricular Dysfunction
Phlebotomy
Stroke Volume
Reference Values
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Porter, S. G., Coats, D., Fischer, P. R., Ou, K., Frank, E. L., Sreang, P., ... Cabalka, A. K. (2014). Thiamine deficiency and cardiac dysfunction in cambodian infants. Journal of Pediatrics, 164(6), 1456-1461. https://doi.org/10.1016/j.jpeds.2014.01.049

Thiamine deficiency and cardiac dysfunction in cambodian infants. / Porter, Samuel G.; Coats, Debra; Fischer, Philip R.; Ou, Kevanna; Frank, Elizabeth L.; Sreang, Phivan; Saing, Soksan; Topazian, Mark; Enders, Felicity T; Cabalka, Allison K.

In: Journal of Pediatrics, Vol. 164, No. 6, 2014, p. 1456-1461.

Research output: Contribution to journalArticle

Porter, SG, Coats, D, Fischer, PR, Ou, K, Frank, EL, Sreang, P, Saing, S, Topazian, M, Enders, FT & Cabalka, AK 2014, 'Thiamine deficiency and cardiac dysfunction in cambodian infants', Journal of Pediatrics, vol. 164, no. 6, pp. 1456-1461. https://doi.org/10.1016/j.jpeds.2014.01.049
Porter SG, Coats D, Fischer PR, Ou K, Frank EL, Sreang P et al. Thiamine deficiency and cardiac dysfunction in cambodian infants. Journal of Pediatrics. 2014;164(6):1456-1461. https://doi.org/10.1016/j.jpeds.2014.01.049
Porter, Samuel G. ; Coats, Debra ; Fischer, Philip R. ; Ou, Kevanna ; Frank, Elizabeth L. ; Sreang, Phivan ; Saing, Soksan ; Topazian, Mark ; Enders, Felicity T ; Cabalka, Allison K. / Thiamine deficiency and cardiac dysfunction in cambodian infants. In: Journal of Pediatrics. 2014 ; Vol. 164, No. 6. pp. 1456-1461.
@article{4c67ae36f6fe486a950a6dd940bc3886,
title = "Thiamine deficiency and cardiac dysfunction in cambodian infants",
abstract = "Objectives To compare blood thiamine concentrations, echocardiography findings, and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in infants with clinically diagnosed beriberi and healthy matched controls, and to evaluate changes after thiamine treatment. Study design Sixty-two Cambodian infants (20 cases and 42 controls), aged 2-47 weeks, were enrolled in this prospective study. Echocardiography and phlebotomy were performed at baseline and after thiamine treatment. Results Both cases and controls were thiamine-deficient, with median blood thiamine diphosphate (TDP) concentrations of 47.6 and 55.1 nmol/L, respectively (P =.23). All subjects had normal left ventricular ejection fraction. The median NT-proBNP concentration in cases (340 pg/mL [40.1 pmol/L]) was higher than previously reported normal ranges, but not statistically significantly different from that in controls (175 pg/mL [20.7 pmol/L]) (P =.10), and was not correlated with TDP concentration (P =.13). Two cases with the lowest baseline TDP concentrations (24 and 21 nmol/L) had right ventricular enlargement and elevated NT-proBNP levels that improved dramatically by 48 hours after thiamine administration. Conclusion Only a minority of thiamine-deficient Cambodian infants demonstrate abnormal echocardiography findings. Thiamine deficiency produces echocardiographic evidence of right ventricular dysfunction, but this evidence is not apparent until deficiency is severe. NT-proBNP concentrations are mildly elevated in sick infants with normal echocardiography findings, indicating possible physiological changes not yet associated with echocardiographic abnormalities.",
author = "Porter, {Samuel G.} and Debra Coats and Fischer, {Philip R.} and Kevanna Ou and Frank, {Elizabeth L.} and Phivan Sreang and Soksan Saing and Mark Topazian and Enders, {Felicity T} and Cabalka, {Allison K.}",
year = "2014",
doi = "10.1016/j.jpeds.2014.01.049",
language = "English (US)",
volume = "164",
pages = "1456--1461",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Thiamine deficiency and cardiac dysfunction in cambodian infants

AU - Porter, Samuel G.

AU - Coats, Debra

AU - Fischer, Philip R.

AU - Ou, Kevanna

AU - Frank, Elizabeth L.

AU - Sreang, Phivan

AU - Saing, Soksan

AU - Topazian, Mark

AU - Enders, Felicity T

AU - Cabalka, Allison K.

PY - 2014

Y1 - 2014

N2 - Objectives To compare blood thiamine concentrations, echocardiography findings, and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in infants with clinically diagnosed beriberi and healthy matched controls, and to evaluate changes after thiamine treatment. Study design Sixty-two Cambodian infants (20 cases and 42 controls), aged 2-47 weeks, were enrolled in this prospective study. Echocardiography and phlebotomy were performed at baseline and after thiamine treatment. Results Both cases and controls were thiamine-deficient, with median blood thiamine diphosphate (TDP) concentrations of 47.6 and 55.1 nmol/L, respectively (P =.23). All subjects had normal left ventricular ejection fraction. The median NT-proBNP concentration in cases (340 pg/mL [40.1 pmol/L]) was higher than previously reported normal ranges, but not statistically significantly different from that in controls (175 pg/mL [20.7 pmol/L]) (P =.10), and was not correlated with TDP concentration (P =.13). Two cases with the lowest baseline TDP concentrations (24 and 21 nmol/L) had right ventricular enlargement and elevated NT-proBNP levels that improved dramatically by 48 hours after thiamine administration. Conclusion Only a minority of thiamine-deficient Cambodian infants demonstrate abnormal echocardiography findings. Thiamine deficiency produces echocardiographic evidence of right ventricular dysfunction, but this evidence is not apparent until deficiency is severe. NT-proBNP concentrations are mildly elevated in sick infants with normal echocardiography findings, indicating possible physiological changes not yet associated with echocardiographic abnormalities.

AB - Objectives To compare blood thiamine concentrations, echocardiography findings, and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in infants with clinically diagnosed beriberi and healthy matched controls, and to evaluate changes after thiamine treatment. Study design Sixty-two Cambodian infants (20 cases and 42 controls), aged 2-47 weeks, were enrolled in this prospective study. Echocardiography and phlebotomy were performed at baseline and after thiamine treatment. Results Both cases and controls were thiamine-deficient, with median blood thiamine diphosphate (TDP) concentrations of 47.6 and 55.1 nmol/L, respectively (P =.23). All subjects had normal left ventricular ejection fraction. The median NT-proBNP concentration in cases (340 pg/mL [40.1 pmol/L]) was higher than previously reported normal ranges, but not statistically significantly different from that in controls (175 pg/mL [20.7 pmol/L]) (P =.10), and was not correlated with TDP concentration (P =.13). Two cases with the lowest baseline TDP concentrations (24 and 21 nmol/L) had right ventricular enlargement and elevated NT-proBNP levels that improved dramatically by 48 hours after thiamine administration. Conclusion Only a minority of thiamine-deficient Cambodian infants demonstrate abnormal echocardiography findings. Thiamine deficiency produces echocardiographic evidence of right ventricular dysfunction, but this evidence is not apparent until deficiency is severe. NT-proBNP concentrations are mildly elevated in sick infants with normal echocardiography findings, indicating possible physiological changes not yet associated with echocardiographic abnormalities.

UR - http://www.scopus.com/inward/record.url?scp=84901485965&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901485965&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2014.01.049

DO - 10.1016/j.jpeds.2014.01.049

M3 - Article

C2 - 24607240

AN - SCOPUS:84901485965

VL - 164

SP - 1456

EP - 1461

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 6

ER -