Abstract
It has been suggested that increased energy expenditure and/or decreased caloric intake may be responsible for reduced growth often seen in patients with congenital heart disease and substantial left-to-right shunting. We hypothesized that infants with moderate-to-large ventricular septal defects(VSD) would exhibit higher rates of total and resting energy expenditure (TEE and REE) rather than decreased caloric intake (EI) compared with healthy control (CTL) infants. Patients with isolated, unoperated VSDs identified by echocardiogram, and healthy CTLs with normal intracardiac anatomy were selected. Patient characteristics are as follows: VSD: n=5, 3.8±0.4 mo, 5.2±1.1 kg; CTL: n=7, 4.0±0.6 mo, 6.9±1.4 kg. Four VSD infants were being treated for congestive heart failure at time of study. REE was measured by indirect calorimetry, TEE and total body water (TBW) were measured by the doubly labeled water method over one week, and EI was calculated from water turnover correcting for metabolic rate and formula composition.
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