title: Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease.
abstract: Left ventricular (LV) mass has been established as an independent risk factor for cardiovascular disease morbidity and mortality. To account for differences in body size, a variety of factors have been proposed for indexing LV mass. Dual energy x-ray absorptiometry provides a measure of lean body mass which can be used as a comparison with other more clinically applicable methods of standardization. The study included 192 subjects (100 male, 103 white) aged 6 to 17 years. Lean body mass was determined by dual energy x-ray absorptiometry and LV mass was calculated from M-mode echocardiographic measurements. There were significant differences by gender (males 98.7 g, females 80.3g, p < 0.001), but not race, for unindexed LV mass. Indexing LV mass by lean body mass eliminated the difference by gender. Log-log regression analysis revealed that the optimal height exponent for indexing LV mass was height3 (95% confidence interval, 2.8 to 3.1). LV mass/height3 provided the most consistently high intraclass correlation with LV mass/lean body mass versus indexing with body surface area, height, height2, and height2.7 across the 4 race/gender groups. LV mass indexed by height3 eliminated differences in LV mass by gender (males 26.1 +/- 4.72 g/m3, females 25.5 +/- 4.8 g/m3, p = NS). The proposed method for indexing LV mass by height3 should be useful in the clinical setting. The 90th and 95th percentiles of LV mass/height3 provide cutpoints for determining the presence of LV hypertrophy in children and adolescents.
authors.affiliation: Department of Pediatrics, University of Cincinnati College of Medicine, Ohio, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Daniels
authors.forename: T R
authors.initials: TR
authors.lastname: Kimball
authors.forename: J A
authors.initials: JA
authors.lastname: Morrison
authors.forename: P
authors.initials: P
authors.lastname: Khoury
authors.forename: R A
authors.initials: RA
authors.lastname: Meyer
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001824:Body Constitution; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases; D002648:Child; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis; D008297:Male; D012016:Reference Values; D012044:Regression Analysis; D012737:Sex Factors