Echocardiographic assessment of left ventricular mass in children with severe malaria at two tertiary institutions in Southeast Nigeria

Left ventricular mass (LVM) and left ventricular hypertrophy (LVH) are important indicators of cardiovascular involvement in children with severe malaria. The left ventricular mass index (LVMI) serves as a valuable tool for assessing cardiac risk in affected children. This study evaluated LVM, LVMI, and the prevalence of LVH among children with severe malaria compared with healthy controls. This cross-sectional analytical study included 100 children with severe malaria and 100 apparently healthy controls aged 6 months to 6 years. Participants were recruited from two tertiary hospitals. Echocardiography was used to assess left ventricular mass (LVM), left ventricular mass index (LVMI), and related structural and functional indices. Data were analyzed using IBM SPSS version 25, with additional exploratory regression analyses. The manuscript records reported LVH frequencies of 10% among children with severe malaria and 4% among controls; however, the direct LVH classification variable was not present in the supplied analytic CSV, so the original significance statistic could not be independently verified. Mean LVM did not differ significantly between groups (38.38 ± 17.93 g vs. 40.28 ± 18.58 g; p = 0.466). Mean LVEF was lower in severe malaria (65.58 ± 13.17% vs. 69.00 ± 9.85%; p = 0.039), while MAPSE was higher (14.38 ± 4.10 vs. 13.31 ± 2.28 mm; p = 0.024). Estimated pulmonary pressure was also higher in severe malaria (17.03 ± 5.86 vs. 14.47 ± 3.89 mmHg; p < 0.001). Twenty-one children (21%) met the severe malarial anaemia definition (Hb < 5 g/dL); mean LVM was not different from the remaining 79 children (38.36 ± 13.89 vs. 38.39 ± 18.90 g; p = 0.995). Mean LVM was not significantly different between children with severe malaria and controls. The available data do not support severe malarial anaemia as an independent driver of increased LVM. Age remained strongly associated with LVM after exploratory adjustment for age and sex, underscoring the importance of accounting for growth and body size in paediatric cardiac assessment.