Serum C-reactive protein levels and body mass index in children and adolescents with CHD

Goulart, Maíra Ribas; Schuh, Daniela Schneid; Moraes, David William; Barbiero, Sandra Mari; Pellanda, Lúcia Campos

doi:10.1017/s1047951116002080

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…The basis of growth failure or underweight in CHD appears to be multifactorial and may differ in aetiology from patient to patient. It includes the underlying cardiac anomaly, 24 haemodynamic factors, hypoxaemia, inadequate calorie, or macronutrient intake, 1,13,[25][26][27][28] increased energy expenditure relative to intake, [29][30][31] increased inflammation, 32 or associated comorbidities that include gut dysfunction, 25 , respiratory infections, associated genetic syndromes, and reduced growth potential. 7,[33][34][35][36][37] A study of anthropometric data in children with CHD in India showed that recorded dietary intake was not associated with the probability of being underweight.…”

Section: Failure To Thrive In Children With Chdmentioning

confidence: 99%

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

et al. 2017

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Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low-and middle-income countries.Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible.Close attention should be paid to nutritional support -primarily enteral feeding, with particular use of breast milk in infancy -in the perioperative period and in the paediatric ICU. This nutritional support requires specific attention and allocation of resources, including appropriately skilled personnel.Thereafter, it is essential to monitor growth and development and to identify causes for failure to catch-up or grow appropriately.

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Section: Failure To Thrive In Children With Chdmentioning

confidence: 99%

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

et al. 2017

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“…34 However, the findings differ from those of studies that have reported a prevalence of 18.2%-35.7% for overweight/obesity in CCHD in Western countries. [11][12][13][14][15][16][17][18][19]35 This suggests that findings from Western studies cannot be generalized for Asian populations and that studies such as the present one are necessary. Our study also indicated that BMI in the CCHD did not differ significantly from the age-and sex-adjusted BMI of the children in the general Taiwanese population.…”

Section: Discussionmentioning

confidence: 86%

“…These studies have determined that over 20% of children with heart disease were overweight or obese. [11][12][13][14][15][16][17][18][19] In adults with congenital heart disease, the prevalence of overweight or obesity is higher (i.e., 50%). [20][21][22][23] CCHD with overweight and obesity face cardiovascular risk factors that may lead to subsequent exacerbated cardiovascular burden into adulthood, such as hypertension, atherosclerosis, coronary artery disease, and diabetes.…”

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confidence: 99%

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

et al. 2020

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Background: Overweight/obesity is a substantial global public health concern, which can be caused by genetic factors and energy balance-related behaviors (EBRBs). If it occurs in children with congenital heart disease (CCHD), it can yield an extra burden on their health. Most studies on CCHD have taken place in Western societies, leaving Asian populations understudied, especially children. Objective: We sought (1) to determine body mass index (BMI) distribution among school-aged CCHD in Taiwan; (2) to ascertain whether the BMI of CCHD differs from that of the general population; (3) to describe EBRBs in CCHD; and (4) to identify the associated factors of underweight and overweight/obesity among CCHD.Methods: In this cross-sectional study, 97 child-parent dyads (53.6% boys; mean age 9.73 years; 25.8% moderate-to-severe heart conditions) were enrolled. Self-administered questionnaires were used to collect demographics, medical factors, food frequency, physical activity, and sedentary behaviors. Anthropometric measurements were taken in the hospital. Independent variables of EBRBs and health conditions were calculated through logistic regression analysis.Results: Among Taiwanese CCHD, 19.6% were underweight and 14.4% were overweight/obesity. Children with moderate-to-severe heart defects were more often underweight. BMI did not differ between CCHD and children in the general population.More complex heart defects and asthma were associated with being underweight, whereas sedentary behaviors, cardiomegaly, and the New York Heart Association Classification Ⅱ-Ⅳ were associated with being overweight/obesity. Conclusions:Sedentary lifestyle is seemingly the only EBRBs correlated with being overweight. Physical activity programs for children may help prevent and treat overweight or obesity in Asian CCHD, similar to Western countries.

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“…Through stimulation of toll-like receptor (TLR)-expressing immune cells, such as monocytes, bacterial endotoxins can induce a significant cytokine production and inflammatory immune response, maintaining an inflammatory state. In addition, hypoxia represents a potential immune stimulus in CHD, since it is known that patients with cyanotic heart defects display particularly elevated TNF-α, IL-6, and higher hsCRP [ 16 – 18 ]. Hypoxia itself induces the transcription of several inflammation-promoting genes, such as NF‑κB and TLRs, via the alpha subunit of the hypoxia-inducible transcription factor (HIF-1α) [ 19 ].…”

Section: Causes and Consequences Of Inflammation And Immune Changes In Chdmentioning

confidence: 99%

Immunity and inflammation: the neglected key players in congenital heart disease?

et al. 2021

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Although more than 90% of children born with congenital heart disease (CHD) survive into adulthood, patients face significantly higher and premature morbidity and mortality. Heart failure as well as non-cardiac comorbidities represent a striking and life-limiting problem with need for new treatment options. Systemic chronic inflammation and immune activation have been identified as crucial drivers of disease causes and progression in various cardiovascular disorders and are promising therapeutic targets. Accumulating evidence indicates an inflammatory state and immune alterations in children and adults with CHD. In this review, we highlight the implications of chronic inflammation, immunity, and immune senescence in CHD. In this context, we summarize the impact of infant open-heart surgery with subsequent thymectomy on the immune system later in life and discuss the potential role of comorbidities and underlying genetic alterations. How an altered immunity and chronic inflammation in CHD influence patient outcomes facing SARS-CoV-2 infection is unclear, but requires special attention, as CHD could represent a population particularly at risk during the COVID-19 pandemic. Concluding remarks address possible clinical implications of immune changes in CHD and consider future immunomodulatory therapies.

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Serum C-reactive protein levels and body mass index in children and adolescents with CHD

Abstract: The correlation between body mass index percentile and C-reactive protein was confirmed in this population. The prevention of overweight is paramount to avoid overlapping modifiable risk factors to those already inherent to the CHD.

Cited by 5 publications

References 40 publications

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

Immunity and inflammation: the neglected key players in congenital heart disease?

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