Indexation criteria of ventricular mass and predictive role of blood pressure and body composition.
BACKGROUND
There is no definite consensus on which indexation of left ventricular mass (LVM) should be used to better identify left ventricular hypertrophy (LVH). Left ventricular mass has been adjusted to height, to height2.7(h2.7) and to body surface area (BSA). The aims of the present study were to evaluate the prevalence of LVH according to different indexations and different cut-offs and to identify the most useful indexation of LVM to detect hypertension-related LVH.


METHODS
Echocardiographic LVH was defined as LVM to h2.7, LVM to BSA, LVM to height, LVM values in the upper 5th percentile of our gender-related LVM distribution, using different partition values suggested in previous population-based studies.


RESULTS
Prevalence of LVH in the general population was 32% using the less restrictive criterion (LVH 49.2/46.7 g/m2.7), 15% with the criterion of LVH 116/104 g/m2, and 3.8% with the most restrictive one (LVH 134/110 g/m2). Prevalence of LVH in hypertensive subjects was almost twice than in normotensive subjects with all criteria. Only 20 subjects out of the 707 evaluated were found to have LVH with all six criteria. In multiple regression analysis SBP was independently associated with nonindexed LVM and was indexed to both BSA and h2.7. On the other hand, fat-free mass was a powerful predictor of nonindexed LVM or of LVM to BSA, whereas body mass index was the strongest predictor of LVM to h2.7.


CONCLUSIONS
The indexation of LVM to BSA, possibly with the cut-off of LVH 116/104, is probably the best criterion for identifying blood pressure-related LVH.
Ferrara
Liberato Aldo
LA
Department of Clinical and Experimental Medicine, Federico 2nd University of Naples, Naples, Italy. ferrara@unina.it
Vaccaro
Olga
O
Cardoni
Ondina
O
Laurenzi
Martino
M
Mancini
Mario
M
Zanchetti
Alberto
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012044:Regression Analysis; D049629:Waist-Hip Ratio
D015415:Biomarkers; D001786:Blood Glucose