| Summary: | Puberty is accompanied by significant changes in hemodynamics that can influence interpretation of clinical states. However the extent to which this is influenced by the nutritional status of children is poorly understood.
To study the changes in cardiac dimensions with onset of early puberty and their relation to growth and nutritional status in females.
Methods: Survey was conducted for 200 schools girls aged 9–12 years including full cardiac exam, blood pressure (BP), weight-for-age (W/A), height-for-age (H/A) and body mass index (BMI) and echocardiography for aortic, atrial and ventricular dimensions, as well pressure gradients and flow velocities. Further analysis was conducted for forty cases that were identified with flow abnormalities.
Findings: Only 17.5% had audible murmurs. Mean BP ranged from 90.4 in the 9 years olds, 94 in the 10 year olds, 95.9 in the 11 year olds and 97.5 in the 12 year olds. Morphologic dimensions were measured for the ventricles, left atria (LA) and aorta (Ao). Aortic dimensions increased with the onset of puberty and correlated with the BMI increase, but the mean aortic to left atrial dimensions were unchanged with puberty onset. Also ventricular dimensions did not change with puberty. The E wave of the mitral valve signal and deceleration velocity showed some change with age, with an exaggerated E wave. BMI averaged 17.1 at 9 years increasing to 21 at 12 years. Underweight (−2SDS) occurred in 22.5% and stunting (−2SDS) in 10% and wasting (underweight for height) in 17.5%. Fifty percent of the children were exposed to passive smoking from family member, 69.2% did not consume a healthy diet and 97% did not practice sports.
Conclusions: Onset of puberty is accompanied by an increase in aortic dimensions to cope with the increased venous return from the developing body systems. Growth disturbances may result in echo abnormalities in flow across the cardiac valves. Improving nutritional status and healthy living lifestyles of children in this period may prevent abnormalities and restore hemodynamics of the heart.
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