Effects of blood pressure percentile, body mass index, and race on left ventricular mass in children

2022 ◽  
pp. 1-6
Author(s):  
Michelle L. Udine ◽  
Jonathan R. Kaltman ◽  
Qianxi Li ◽  
Jin Liu ◽  
Deyu Sun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
African American ◽  
Left Ventricular Hypertrophy ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Left Ventricle Mass ◽  
African American Race

Abstract Objective: To evaluate the association of systolic blood pressure percentile, race, and body mass index with left ventricular hypertrophy on electrocardiogram and echocardiogram to define populations at risk. Study design: This is a retrospective cross-sectional study design utilising a data analytics tool (Tableau) combining electrocardiogram and echocardiogram databases from 2003 to 2020. Customized queries identified patients aged 2–18 years who had an outpatient electrocardiogram and echocardiogram on the same date with available systolic blood pressure and body measurements. Cases with CHD, cardiomyopathy, or arrhythmia diagnoses were excluded. Echocardiograms with left ventricle mass (indexed to height2.7) were included. The main outcome was left ventricular hypertrophy on echocardiogram defined as Left ventricle mass index greater than the 95th percentile for age. Results: In a cohort of 13,539 patients, 6.7% of studies had left ventricular hypertrophy on echocardiogram. Systolic blood pressure percentile >90% has a sensitivity of 35% and specificity of 82% for left ventricular hypertrophy on echocardiogram. Left ventricular hypertrophy on electrocardiogram was a poor predictor of left ventricular hypertrophy on echocardiogram (9% sensitivity and 92% specificity). African American race (OR 1.31, 95% CI = 1.10, 1.56, p = 0.002), systolic blood pressure percentile >95% (OR = 1.60, 95% CI = 1.34, 1.93, p < 0.001), and higher body mass index (OR = 7.22, 95% CI = 6.23, 8.36, p < 0.001) were independently associated with left ventricular hypertrophy on echocardiogram. Conclusions: African American race, obesity, and hypertension on outpatient blood pressure measurements are independent risk factors for left ventricular hypertrophy in children. Electrocardiogram has little utility in the screening for left ventricular hypertrophy.

Abstract 15047: Effects of Blood Pressure Percentile, Body Mass Index, and Race on Left Ventricular Mass in Children

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michelle L Udine ◽  
Jonathan Kaltman ◽  
Qianxi Li ◽  
Jin Liu ◽  
Deyu Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
African American ◽  
Body Mass ◽  
Left Ventricular ◽  
Left Ventricle Mass ◽  
Cross Sectional ◽  
Populations At Risk ◽  
African American Race

Introduction: Childhood hypertension, obesity, and left ventricular hypertrophy (LVH) are risk factors for premature cardiovascular events in adulthood, particularly among minorities. In children, race and body mass index (BMI) have been shown to be independently associated with LVH, with conflicting data on the association of systolic blood pressure (SBP) level with risk of LVH and utility of ECG in assessing LVH. This study looks at the association of SBP percentile, race, and BMI with LVH on electrocardiogram (ECG) and echocardiogram (echo) to define populations at risk. Methods: This is a retrospective cross-sectional study design utilizing a data analytics tool (Tableau) combining ECG and echo databases from 2003-2020. Customized queries identified patients ages 2-18 years old who had an outpatient ECG and echo on the same date with available SBP and body measurements. Cases with congenital heart disease, cardiomyopathy, or arrhythmia diagnoses were excluded. Echos with left ventricle mass (indexed to height 2.7 ) were included. The main outcome was LVH on echo defined as LV mass index greater than the 95 th percentile for age. Results: In a cohort of 13,926 patients, 6.9% of studies had LVH on echo. SBP percentile > 90% has a sensitivity of 36% and specificity of 82% for LVH on echo. LVH on ECG was a poor predictor of LVH on echo (9% sensitivity and 92% specificity). African American race (OR 1.31, 95% CI = 1.11, 1.55, p=.001), SBP percentile > 95% (OR=1.64, 95% CI = 1.37, 1.95, p <.001), and higher body mass index (OR= 7.43, 95% CI = 6.44, 8.55, p <.001) were independently associated with LVH on echo. Figure 1 shows the prevalence of LVH by African American race, obesity, and SBP. Conclusions: African American race, obesity, and hypertension are independent risk factors for LVH in children. Outpatient ECG has low utility in screening for LVH.

scholarly journals FREQUENCY AND RISK FACTORS OF LEFT VENTRICULAR GEOMETRIC ABNORMALITIES IN HYPERTENSIVE PATIENTS: A STUDY BASED ON THE UPDATED CLASSIFICATION SYSTEM OF LEFT VENTRICULAR GEOMETRY

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S695-700
Author(s):  
Fauzia Nazir ◽  
Tahir Iqbal ◽  
Javeria Kamran ◽  
Tariq Hussain Khattak ◽  
Anum Fatima ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Left Ventricular Hypertrophy ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Concentric Left Ventricular Hypertrophy ◽  
Elevated Systolic Blood Pressure

Objective: To determine the association between cardiovascular risk factors and the abnormalities of left ventricular geometric abnormalities. Study Design: Prospective cross-sectional, single centered study. Place and Duration of Study: Armed Forces Institute of Cardiology, Rawalpindi, from Jun 2018 to Dec 2018. Methodology: This study permission was sought from hospital ethics committee. Written informed consent was taken from participants of study. Particulars of all the patients who meet the inclusion were included i.e., 351 hypertensive. Results: Left ventricular geometric abnormalities were detected in 321 subjects (91%), wherein concentric non dilated left ventricular hypertrophy is the most common left ventricular geometric abnormality (39%). Elevated systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular remodeling, whereas body mass index and chronic kidney disease were inversely associated with concentric abnormalities. systolic blood pressure and diabetes mellitus, chronic kidney disease, large WC were positively associated with eccentric dilated left ventricular hypertrophy, while body mass index, duration of hypertension, MS were inversely associated with eccentric dilated left ventricular hypertrophy. Elevated systolic blood pressure was the strongest risk factor for eccentric dilated left ventricular hypertrophy. Large WC, systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular hypertrophy, whereas body mass index was negatively associated with concentric left ventricular hypertrophy. Conclusion: Appropriate risk factor management and compliance can prevent left ventricular geometric abnormalities hence poorer outcomes in our population

OP-015 RELATIONSHIP BETWEEN BODY MASS INDEX AND LEFT VENTRICULAR HYPERTROPHY IN ASYMPTOMATIC ADOLESCENTS

2012 ◽  
Vol 155 ◽  
pp. S2-S3
Author(s):  
A.B. Kepuska ◽  
A. Batalli ◽  
M. Zejnullahu ◽  
M. Shala ◽  
M. Azemi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricular Hypertrophy ◽  
Body Mass ◽  
Ventricular Hypertrophy ◽  
Left Ventricular

scholarly journals Association of Interarm Systolic Blood Pressure Difference with Atherosclerosis and Left Ventricular Hypertrophy

PLoS ONE ◽  
2012 ◽  
Vol 7 (8) ◽  
pp. e41173 ◽  
Author(s):  
Ho-Ming Su ◽  
Tsung-Hsien Lin ◽  
Po-Chao Hsu ◽  
Chun-Yuan Chu ◽  
Wen-Hsien Lee ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Systolic Blood Pressure ◽  
Pressure Difference ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Blood Pressure Difference

scholarly journals FGF23 and Left Ventricular Hypertrophy in Children with CKD

2017 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Mark M. Mitsnefes ◽  
Aisha Betoko ◽  
Michael F. Schneider ◽  
Isidro B. Salusky ◽  
Myles Selig Wolf ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricular Hypertrophy ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Adjusted Odds Ratio ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Interquartile Range

Background and ObjectivesHigh plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.Design, setting, participants, & measurementsWe performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH (LVMI ≥95th percentile), adjusted for demographics, body mass index, eGFR, and CKD-specific factors. We also examined the relationship between FGF23 and LVH by eGFR level.ResultsMedian age was 12 years (interquartile range, 8–15) and eGFR was 50 ml/min per 1.73 m2 (interquartile range, 38–64). Overall prevalence of LVH was 11%. After adjustment for demographics and body mass index, the odds of having LVH was higher by 2.53 (95% confidence interval, 1.28 to 4.97; P<0.01) in participants with FGF23 concentrations ≥170 RU/ml compared with those with FGF23<100 RU/ml, but this association was attenuated after full adjustment. Among participants with eGFR≥45 ml/min per 1.73 m2, the prevalence of LVH was 5.4%, 11.2%, and 15.3% for those with FGF23 <100 RU/ml, 100–169 RU/ml, and ≥170 RU/ml, respectively (Ptrend=0.01). When eGFR was ≥45 ml/min per 1.73 m2, higher FGF23 concentrations were independently associated with LVH (fully adjusted odds ratio, 3.08 in the highest versus lowest FGF23 category; 95% confidence interval, 1.02 to 9.24; P<0.05; fully adjusted odds ratio, 2.02 per doubling of FGF23; 95% confidence interval, 1.29 to 3.17; P<0.01). By contrast, in participants with eGFR<45 ml/min per 1.73 m2, FGF23 did not associate with LVH.ConclusionsPlasma FGF23 concentration ≥170 RU/ml is an independent predictor of LVH in children with eGFR≥45 ml/min per 1.73 m2.

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