ArticleThe Journal of infectious diseases2020
Reduced Cardiac Index Reserve and Hypovolemia in Severe Falciparum Malaria.
Article in The Journal of infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Development of a Disease-Specific Virtual Malaria Population for Physiologically-Based Pharmacokinetic Modeling.CPT: pharmacometrics & systems pharmacology · 2026Article
- Echocardiographic assessment of cardiac function in children with severe malaria attending two tertiary hospitals in southeast Nigeria.European journal of pediatrics · 2026Observational
- Mechanism of Immune Evasion in Mosquito-Borne Diseases.Pathogens (Basel, Switzerland) · 2023Review
- Point-of-care ultrasound to assess volume status and pulmonary oedema in malaria patients.Infection · 2022Observational
- Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study.Frontiers in medicine · 2021Article
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Authors and funding
17 authors at 10 institutions in 6 countries.
Funding
Abstract
backgroundImpaired microvascular perfusion is central to the development of coma and lactic acidosis in severe falciparum malaria. Refractory hypotension is rare on admission but develops frequently in fatal cases. We assessed cardiac function and volume status in severe falciparum malaria and its prognostic significance.
methodsPatients with severe (N = 101) or acute uncomplicated falciparum malaria (N = 83) were recruited from 2 hospitals in India and Bangladesh, and healthy participants (N = 44) underwent echocardiography.
resultsPatients with severe malaria had 38% shorter left ventricular (LV) filling times and 25% shorter LV ejection times than healthy participants because of tachycardia; however, stroke volume, LV internal diameter in diastole (LVIDd), and LV internal diameter in systole (LVIDs) indices were similar. A low endocardial fraction shortening (eFS) was present in 17% (9 of 52) of severe malaria patients. Adjusting for preload and afterload, eFS was similar in health and severe malaria. Fatal cases had smaller baseline LVIDd and LVIDs indices, more collapsible inferior vena cavae (IVC), and higher heart rates than survivors. The LVIDs and IVC collapsibility were independent predictors for mortality, together with base excess and Glasgow Coma Scale.
conclusionsPatients with severe malaria have rapid ejection of a normal stroke volume. Fatal cases had features of relative hypovolemia and reduced cardiac index reserve.
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