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 language | English (US) |
|---|---|
| Pages (from-to) | 1456-1461 |
| Number of pages | 6 |
| Journal | Journal of Pediatrics |
| Volume | 164 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2014 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
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 journal › Article
}
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 -