Left ventricular mass by echocardiographic measures in children and adolescents

2012 ◽  
Vol 23 (5) ◽  
pp. 727-737 ◽  
Author(s):  
Sudhir K. Mehta
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Surface Area ◽  
Left Ventricular Mass ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Left Ventricular ◽  
Ventricular Mass ◽  
Cardiovascular Morbidity And Mortality

AbstractBackgroundRecent evidence in adults suggests that left ventricular mass measured as left ventricular mass/height1.7 predicts cardiovascular morbidity and mortality better than the two widely used indices, left ventricular mass/body surface area and left ventricular mass/height2.7. Standards of left ventricular mass/height1.7 have not been reported in children, for whom, owing to lack of significant cardiovascular morbidity and mortality, body mass index has traditionally been used as a potential cardiovascular risk factor.MethodsIn this retrospective study, 692 clinically normal children aged 1 day to 18 years underwent detailed echocardiographic assessment to assess whether any of the left ventricular mass indices – left ventricular mass/height1.7, left ventricular mass/body surface area, and left ventricular mass/height2.7 – are associated with obesity as measured by body mass index. Correlations, t-tests, and linear regressions were used for statistical testing.ResultsLeft ventricular mass/height1.7 was better correlated (R2 = 0.36) with body mass index than left ventricular mass/body surface area (R2 = 0.179) and left ventricular mass/height2.7 (R2 = 0.006), although all three dependent variables show a significant correlation (p < 0.035). In addition, a higher percentage of obese patients were noted to have elevated left ventricular mass as measured by left ventricular mass/height1.7 than by the other two methods.ConclusionsLeft ventricular mass/height1.7 is a reliable indicator of obesity-associated left ventricular hypertrophy. Left ventricular mass/height1.7 can be used conveniently during transitions from youth to adults for long-term follow-up. These findings support the importance of including left ventricular mass/height1.7 in future studies of cardiovascular risks and preventive strategies in children and adolescents.

scholarly journals Maternal Cardiac Assessment at 35 to 37 Weeks Improves Prediction of Development of Preeclampsia

Hypertension ◽  
2020 ◽  
Vol 76 (2) ◽  
pp. 514-522 ◽  
Author(s):  
Coral Garcia-Gonzalez ◽  
Georgios Georgiopoulos ◽  
Samira Abdel Azim ◽  
Fernando Macaya ◽  
Nikos Kametas ◽  
...  
Keyword(s):  
Surface Area ◽  
Left Ventricular Mass ◽  
Body Surface Area ◽  
Risk Score ◽  
Body Surface ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Interquartile Range ◽  
Ventricular Mass ◽  
Cardiac Indices

Preeclampsia at term accounts for half of maternal deaths from hypertensive disorders. We aimed to assess differences in maternal cardiac indices at 35 +0 to 36 +6 weeks’ gestation between women who subsequently developed preeclampsia at term compared with those with uncomplicated pregnancy and to evaluate whether cardiac indices offer incremental prognostic value to the available screening algorithm for preeclampsia. We recruited 1602 women with singleton pregnancies who attended for a routine hospital visit at 35 +0 to 36 +6 weeks’ gestation between April and November 2018. We recorded maternal characteristics and preeclampsia-risk-score derived from a competing risks model and measured cardiac indices. Preeclampsia developed in 3.12% (50/1602) of participants. Women with preeclampsia, compared with those without, had increased mean arterial pressure (97.6, SD, 5.53 versus 87.9, SD, 6.82 mm Hg), systemic vascular resistance (1500, interquartile range, 1393–1831 versus 1400, interquartile range, 1202–1630 PRU) and preeclampsia-risk-score (23.4, interquartile range, 9.13–40 versus 0.9, interquartile range, 0.32–3.25). Multivariable analysis demonstrated independent association between the incidence of preeclampsia and E/e′ (hazard ratio, 1.19/unit [95% CI, 1.03–1.37]; P =0.018) as well as left ventricular mass indexed for body surface area (hazard ratio, 1.03/[g·m 2 ] [95% CI, 1.003–1.051]; P =0.029). Women with E/e′ ≥7.3 and left ventricular mass indexed for body surface area ≥63.2 g/m 2 had an increased risk for developing preeclampsia, despite low preeclampsia-risk-score <5% (hazard ratio, 20.1 [95% CI, 10.5–38.7], P <0.001). Increased left ventricular mass and E/e′ offer incremental information to available scoring systems and better stratify women at risk of developing preeclampsia at term.

scholarly journals Lean body mass is the strongest anthropometric predictor of left ventricular mass in the obese paediatric population

2020 ◽  
Vol 30 (4) ◽  
pp. 476-481
Author(s):  
James R. Shea ◽  
Melissa H. Henshaw ◽  
Janet Carter ◽  
Shahryar M. Chowdhury
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Surface Area ◽  
Left Ventricular Mass ◽  
Lean Body Mass ◽  
Body Mass ◽  
Body Surface ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Obese Children ◽  
Ventricular Mass

AbstractBackground:Indexing left ventricular mass to body surface area or height2.7 leads to inaccuracies in diagnosing left ventricular hypertrophy in obese children. Lean body mass predictive equations provide the opportunity to determine the utility of lean body mass in indexing left ventricular mass. Our objectives were to compare the diagnostic accuracy of predicted lean body mass, body surface area, and height in detecting abnormal left ventricle mass in obese children.Methods:Obese non-hypertensive patients aged 4–21 years were recruited prospectively. Dual-energy X-ray absorptiometry was used to measure lean body mass. Height, weight, sex, race, and body mass index z-score were used to calculate predicted lean body mass.Results:We enrolled 328 patients. Average age was 12.6 ± 3.8 years. Measured lean body mass had the strongest relationship with left ventricular mass (R2 = 0.84, p < 0.01) compared to predicted lean body mass (R2 = 0.82, p < 0.01), body surface area (R2 = 0.80, p < 0.01), and height2.7 (R2 = 0.65, p < 0.01). Of the clinically derived variables, predicted lean body mass was the only measure to have an independent association with left ventricular mass (β = 0.90, p < 0.01). Predicted lean body mass was the most accurate scaling variable in detecting left ventricular hypertrophy (positive predictive value = 88%, negative predictive value = 99%).Conclusions:Lean body mass is the strongest predictor of left ventricular mass in obese children. Predicted lean body mass is the most accurate anthropometric scaling variable for left ventricular mass in left ventricular hypertrophy detection. Predicted lean body mass should be considered for clinical use as the body size correcting variable for left ventricular mass in obese children.

Abstract P261: Associations of Left Ventricular Mass, Total Body Weight, and Fat-Free Mass With Body Mass Index: The Framingham Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Philimon N Gona ◽  
Jane J Lee ◽  
Carol J Salton ◽  
Saadia Qazi ◽  
Christopher J O'Donnell ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricular Mass ◽  
Body Mass ◽  
Linear Trend ◽  
Left Ventricular ◽  
Fat Free Mass ◽  
Total Body Mass ◽  
Ventricular Mass ◽  
Cardiovascular Morbidity And Mortality ◽  
Total Body

Introduction: Increased left ventricular mass (LVM) predicts excess cardiovascular morbidity and mortality. LVM is often indexed to height (HT) or body surface area (BSA). HT-indexation ignores weight and thus obesity. The relationship of indexed LVM with weight, obesity, and adiposity is unclear. We investigated the association of LVM with total-body mass (TBM, i.e. weight) and fat-free mass (FFM), hypothesizing that LVM scales better to FFM than TBM. Methods: From the 1794 members of Framingham Offspring cohort who underwent cardiac magnetic resonance (CMR), we identified 845 (aged 65±9y) without any history of hypertension, myocardial infarction, heart failure, or CMR wall-motion abnormality. LVM was measured from cine bSSFP images and indexed to HT, BSA, TBM and FFM (by DEXA). Participants were stratified by sex and body mass index (BMI) category (NL=BMI 18.5 - 24.9; OW=25.0 - 29.9; OB=30.0+ kg/m 2 ). We used sex-specific ANCOVA to test for linear trend across BMI categories, and determined sex-specific Pearson correlation coefficients of LVM with BMI; both sets of analyses were adjusted for age and systolic blood pressure. Data are summarized as mean ± SD. Results: The Table shows that LVM and LVM/HT increase with greater BMI-category in both sexes. LVM/BSA was similar across BMI-categories, while LVM/TBM decreased. There was no linear trend across BMI-categories for LVM/FFM in either sex. On a continuous basis, LVM and LVM/HT were positively correlated with BMI in both sexes (r=0.20 to 0.35, p<0.001 for all); LVM/BSA was weakly inversely correlated with BMI in women only (r=-0.14, p=0.001) but not men (r=-0.08, p=0.18); LVM/TBM was inversely correlated with BMI (M: r=-0.39, W: r=-0.54; p<0.0001 both); LVM/FFM was not correlated with BMI in either sex (M: r=-0.05, p=0.38, W: r=0.08, p=0.055). Conclusion: LVM as a proportion of TBM (weight) actually decreases with greater BMI, while LVM/FFM is not associated with BMI. Whether LVM is better scaled to FFM vs HT, BSA or TBM for risk stratification purposes remains to be determined.

Assessment of left ventricular mass and volume by cross-sectional echocardiography in newborns and infants with tricuspid atresia prior to surgical intervention

1993 ◽  
Vol 3 (1) ◽  
pp. 34-38
Author(s):  
Michael Vogel ◽  
Jan Skovaranek ◽  
Konrad Bühlmeyer
Keyword(s):  
Surface Area ◽  
Left Ventricular Mass ◽  
Body Surface Area ◽  
Body Surface ◽  
Left Ventricular Volume ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Tricuspid Atresia ◽  
Ventricular Mass ◽  
Normal Left Ventricular

SummaryBecause left ventricular mass may be important in judging feasibility of Fontan type of palliation in tricuspid atresia, this study was undertaken to generate data on left ventricular mass, volume and mass to volume ratio in newborns and infants with tricuspid atresia, native pulmonary stenosis and concordant ventriculoarterial connections prior to any surgical palliation to obtain values for “normal” left ventricular dimensions in tricuspid atresia. The left ventricle was evaluated in the apical two and four chamber view. From these two perpendicular imaging planes, we calculated mass as difference between epicardial and endocardial volume x 1.05 (specific gravity of heart muscle). Mass divided by volume at end-diastole yields the index: mass to volume. Data from 23 newborns and infants with tricuspid atresia were compared to data from 30 age-matched controls with normal hearts. In both patient and control groups, growth of the left ventricle was not linear but related to the 1.4 (volume) or 1.25 (mass) power of body surface area. The equation best describing relation between left ventricular volume and body surface area in normals is volume = 60.7(body surface area)1.4−0.2 ml; in patients with tricuspid atresia volume calculates as 96.7(body surface area)1.4+0.9 ml. In relation to normal infants, infants with tricuspid atresia had a left ventricular volume of 167 (135–206)% of normal and a left ventricular mass of 163 (132–201)% of normal. Left ventricular mass assessed in normals calculates as mass = 59.9(body surface area)1.25+1.3 grams; in patients with tricuspid atresia it calculates as mass= 117.5 (body surface area)1.25−0.9 grams. The index of left ventricular mass to volume in patients with tricuspid atresia measured 1.32, not significantly different from controls, in whom this index calculates as 1.34.

scholarly journals Reference values of left heart echocardiographic dimensions and mass in male peri-pubertal athletes

2018 ◽  
Vol 25 (11) ◽  
pp. 1204-1215 ◽  
Author(s):  
Elena Cavarretta ◽  
Francesco Maffessanti ◽  
Fabio Sperandii ◽  
Emanuele Guerra ◽  
Federico Quaranta ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Atrium ◽  
Surface Area ◽  
Left Ventricular Mass ◽  
Body Surface Area ◽  
Body Surface ◽  
Aortic Root ◽  
Left Ventricular ◽  
Left Heart ◽  
And Training

Background Several articles have proposed reference values in healthy paediatric subjects, but none of them has evaluated a large population of healthy trained adolescents. Design The study purpose was to establish normal echocardiographic measurements of left heart (aortic root, left atrium and left ventricular dimensions and mass) in relation to age, weight, height, body mass index, body surface area and training hours in this specific population. Methods We retrospectively evaluated 2151 consecutive, healthy, peri-pubertal athletes (100% male, mean age 12.4 ± 1.4 years, range 8–18) referred to a single centre for pre-participation screening. All participants were young soccer athletes who trained for a mean of 7.2 ± 1.1 h per week. Results Left ventricular internal diameters, wall thickness, left ventricular mass, aortic root and left atrium diameters were significantly correlated to age, body surface area, height and weight ( p < 0.01). Age, height, weight and body surface area were found associated with chamber size, while body mass index and training hours were not. Inclusion of both age and body size parameters in the statistical models resulted in improved overall explained variance for diameters and left ventricular mass. Conclusion Equations, mean values and percentile charts for the different age groups may be useful as reference data in efficiently assessing left ventricular parameters in young athletes.

Limitations of Expressing Left Ventricular Mass Relative to Height and to Body Surface Area in Children

2013 ◽  
Vol 26 (4) ◽  
pp. 410-418 ◽  
Author(s):  
Bethany J. Foster ◽  
Tao Gao ◽  
Andrew S. Mackie ◽  
Babette S. Zemel ◽  
Huma Ali ◽  
...  
Keyword(s):  
Surface Area ◽  
Left Ventricular Mass ◽  
Body Surface Area ◽  
Body Surface ◽  
Left Ventricular ◽  
Ventricular Mass
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