Doğumsal kalp hastalıkları ve büyüme geriliği

Year 2007, Volume: 14 Issue: 4, 44 - 47, 06.05.2009

Nihal Dündar Bumin Dündar Bumin Dündar Faruk Öktem Faruk Öktem

Abstract

Süleyman Demirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2007 Aralık; 14(4)










Doğumsal kalp hastalıkları ve büyüme geriliği



*Nihal Dündar, **Bumin Dündar, ***Faruk Öktem

*Gülkent Devlet Hastanesi, Çocuk Sağlığı ve Hastalıkları

**Süleyman Demirel Üniversitesi Tıp Fakültesi, Pediatrik Endokrinoloji Bilim Dalı

***Süleyman Demirel Üniversitesi Tıp Fakültesi, Pediatrik Nefroloji Bilim Dalı



Özet



Büyüme geriliği doğumsal kalp hastalıklarının (DKH) iyi bilinen bir komplikasyonu olup, hala DKH.lı çocuklarda önemli bir problem olmaya devam etmektedir. Bu hastalardaki büyüme geriliği, düzeltme ameliyatlarında gecikmeye ve ameliyat sonrası morbiditede risk artışına neden olmaktadır. Bu tür hastalarda, yetersiz kalori alımı, artmış enerji ihtiyacı, malabsorbsiyon, hastalık şiddeti ve hipoksi büyüme yetersizliğinde en önemli büyüme geriliği nedenleridir. Bununla birlikte yetersiz büyümeyle ilgili mekanizmalar hala tartışmalıdır. Son zamanlarda endokrin faktörler üzerinde durulmuş ve siyanotik ve asiyanotik DKH.da büyüme geriliği ile ilişkili düşük insülin benzeri büyüme faktörü-1 düzeyleri bildirilmiştir. Bu derlemede, DKH.lı çocuklardaki büyüme geriliğinin sıklığı, mekanizmaları ve bu olguların büyümelerini iyileştirmedeki yenilikler tartışılmıştır.



Anahtar kelimeler: doğumsal kalp hastalığı, büyüme geriliği,



Abstract



Congenital Heart Diseases and Growth Failure



Growth failure is a well-recognized complication of congenital heart disease (CHD) and still an important problem for children with CHD. Growth failure in these children cause delay in surgical correction and increased risk of morbidity postoperatively. Inadequate caloric intake, increased energy requirements, malabsorption, severity of disease and hypoxia appears to be the most important factors in growth failure of CHD. However, underlying mechanisms of growth failure is still controversial. The role of endocrine factors has been evaluated recently and low serum insulin like growth factor-1 levels associated with growth delay have been reported in both cyanotic and acyanotic CHD. In the following rewiew, incidence, mechanisms of growth failure and recent methods of improving growth and catch-up growth in children with CHD are discussed.



Key words: congenital heart disease, growth failure

Keywords

doðumsal kalp hastalýðý, büyüme geriliði

References

• Lifshitz F, Tarým Ö. Nutritional Growth Retardation.
• In: Lýfshýtz F, ed. Pediatric Endocrinology. Newyork, Marcel Dekker, 1996;103-220.
• Mehrizi A, Drash A. Growth disturbance in congenital heart disease. J Pediatr 1962;61:418-29.
• Hoffman JI. Congenital heart disease: incidence and inheritance. Pediatr Clin North Am 1990;37:25-9.
• Huse DM, Feldt RH, Nelson RA, Novak LP. Food intake, body weight, and energy metabolism. Infants with congenital heart disease. Am J Dis Child 1975;129:65-9.
• Naeye RL. Anatomic features of growth failure in congenital heart disease. Pediatrics 1967;39:433-40.
• Krieger I. Growth failure and congenital heart disease: energy and nitrogen balance in infants. Am J Dis Child 1970;120:497-502.
• Webb JG, Kiess MC, Chan-Yan CC. Malnutrition and the heart. Can Med Assoc J 1986;135:753-8.
• Pittman JG, Cohen P. The pathogenesis of cardiac cachexia. N Engl J Med 1964;271:403-9.
• Strangway A, Fowler R, Cunningham K, Hamilton JR. Diet and growth in congenital heart disease. Pediatrics 1976;57:75-86.
• Bumin Dündar. Doðumsal Kalp Hastalýðý ve Büyüme Geriliði Arasýndaki Ýliþkinin Araþtýrýlmasý. Uzmanlýk Tezi, Dokuz Eylül Üniversitesi Týp Fakültesi Pediatri Anabilim Dalý, Ýzmir, 1998.
• Menon G, Poskitt EM. Why does congenital heart disease cause failure to thrive? Arch Dis Child 1985;60:1134-9.
• Barton JS, Hindmarsh PC, Scrimgeour CM, Rennie MJ, Preece MA. Energy expenditure in congenital heart disease. Arch Disease Child 1994;70:5-9.
• Sondheimer JM, Hamilton JR. Intestinal function in infants with severe congenital heart disease. J Pediatr 1978;92:572-8.
• Özme Þ. Kalp hastalýklý çocuklarda beslenmeyi etkileyen faktörler ve beslenmenin düzenlenmesi. Katký 1996;17:410-8.
• Dorup I, Clausen T. Effects of potassium deficiency on growth and protein synthesis in skeletal muscle and the heart. Br J Nutr 1989;62:269-84.
• Flyvbjerg A, Dorup I, Everts ME, Orskov H. Evidence that potassium deficiency induces growth retardation through reduced circulating levels of growth hormone and insulin-like growth factor I. Metabolism 1991;40:769-75.
• Dorup I, Clausen T. Effects of magnesium and zinc deficiencies on growth and protein synthesis in skelatal muscle and the heart. Br J Nutr 1991;66:493-504.
• Dorup I, Flyvbjerg A, Everts ME, Clausen T. Role of insulin like growth factor 1 and growth hormone in growth inhibition induced by magnesium and zinc deficiencies. Br J Nutr 1991;66:505-21.
• Noonan JA. Syndromes associated with cardiac defects. Cardiovasc Clin 1981;11:97-102.
• Adams FH, Lund GW, Disenhouse RB. Observations on the physique and growth of children with congenital heart disease. J Pediatr 1954;44:674-80.
• Dundar B, Akcoral A, Saylam G, Unal N, Mese T, Hudaoglu S et al. Chronic hypoxemia leads to reduced serum IGF-I levels in cyanotic congenital heart disease. J Pediatr Endocrinol Metab 2000;13:431-6.
• Soliman AT, Madkour A, Galil MA, El Zalabany M, Aziz SM, Ansari BM. Growth parameters and endocrine function in relation to echocardiographic parameters in children with ventricular septal defect without heart failure. J Trop Pediatr 2001;47:146-52.
• Schwartz SM, Gewitz MH, See CC, Berezin S, Glasman MS, Medow CM et al. Enteral nutrition in infants with congenital heart disease and growth failure. Pediatrics 1990;86:368-73.
• Bougle D, Iselin M, Kahyat A, Duhamel JF. Nutritional treatment of congenital heart disease. Arch Dis Child 1986;61:799-801.
• Sasaki H, Baba K, Nishida Y, Waki K, Konishi N, Mawatari H et al. Treatment of children with congenital heart disease and growth retardation with recombinant human growth hormone. Acta Paediatr 1996;85:251- 3.