scholarly journals Cardiac and aortic size measures in adult echocardiography should be indexed by body surface area regardless of body mass index

2021 ◽  
Author(s):  
Angus Fung ◽  
Dhnanjay Soundappan ◽  
Daniel E Loewenstein ◽  
David Playford ◽  
Geoffrey Strange ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Size ◽  
Right Ventricular ◽  
Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Prognostic Performance ◽  
C Statistic ◽  
Atrial Area ◽  
Aortic Size

AbstractBACKGROUNDBody size indexation is a foundation of the diagnostic interpretation of cardiac size measures used in imaging assessment of cardiovascular health. Body surface area (BSA) is the most commonly used metric for body size indexation of echocardiographic measures, but its use in patients who are underweight or obese is questioned (body mass index (BMI) <18·5 kg/m2 or ≥30 kg/m2, respectively). We hypothesized that mortality can be used to identify an optimal body size indexation metric for echocardiographic measures that would be a better predictor of survival than BSA regardless of BMI.METHODSIn this big data, cohort study, adult patients with no prior valve replacement were selected from the National Echo Database Australia. Survival analysis was performed for echocardiographic measures both unindexed and indexed to different body size metrics, with 5-year cardiovascular mortality as the primary endpoint.FINDINGSIndexation of echocardiographic measures (left ventricular diameter [n=337,481] and mass [n=330,959], left atrial area [n=136,989], aortic sinus diameter [n=125,130], right atrial area [n=81,699], right ventricular diameter [n=3,575], right ventricular outflow tract diameter [n=2,841]) by BSA had better prognostic performance vs unindexed measures (healthy/overweight: C-statistic 0·656 vs 0·618, average change in Akaike Information Criteria (ΔAIC) 800; underweight: C-statistic 0·669 vs 0·654, ΔAIC 15; obese: C-statistic 0·630 vs 0·612, ΔAIC 113). Indexation by other body size metrics (lean body mass or height and/or weight raised to various powers) did not improve prognostic performance versus BSA by a clinically relevant magnitude (average C-statistic increase ≤0·01), with smaller differences in higher BMI subgroups. Similar results were obtained using sex-disaggregated analysis, for indexation of other aortic or cardiac dimension or volume measures, and for all-cause mortality.INTERPRETATIONIndexing measures of cardiac and aortic size by BSA improves prognostic performance regardless of BMI, and no other body size metric has a clinically meaningful better performance.FUNDINGThis research was supported in part by grants (PI Ugander) from New South Wales Health, Heart Research Australia, and the University of Sydney.

Body Mass Index and Body Surface Area and Their Associations with Outcomes in Stage II and III Colon Cancer

2012 ◽  
Vol 44 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Sina Alipour ◽  
Hagen F. Kennecke ◽  
Ryan Woods ◽  
Howard J. Lim ◽  
Caroline Speers ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Stage Ii

Kidney Size and Body Size in the Context of Salt and Blood Pressure

1982 ◽  
Vol 63 (s8) ◽  
pp. 419s-421s
Author(s):  
F. O. Simpson ◽  
R. Doesburg ◽  
A. G. Dempster ◽  
M. Kihara ◽  
Y. Yamori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Size ◽  
Surface Area ◽  
Body Surface ◽  
Sodium Intake ◽  
Kidney Weight ◽  
Kidney Size ◽  
European Origin ◽  
New Zealanders

1. Kidney weight was analysed for Japanese and New Zealanders of European origin who had died sudden deaths. 2. Kidney weight was relatively greater in Japanese than in New Zealanders. 3. Kidney weight was closely related to body surface area and weight and less closely to height and body mass index. 4. As kidney function is related to kidney size and thus in turn to body size it is advisable to take account of body size in analyses of sodium intake and excretion in relation to blood pressure.

scholarly journals Body surface area is a predictor of coronary artery calcium, whereas body mass index is not

2012 ◽  
Vol 23 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Sion K. Roy ◽  
Irfan Zeb ◽  
Jigar Kadakia ◽  
Dong Li ◽  
Matthew J. Budoff
Keyword(s):  
Body Mass Index ◽  
Coronary Artery ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Coronary Artery Calcium

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.

Body mass index and body surface area in scleroderma patients

2017 ◽  
Vol 32 (5) ◽  
pp. e164-e165 ◽  
Author(s):  
D. Wcisło-Dziadecka ◽  
A. Kaźmierczak ◽  
M. Zbiciak-Nylec ◽  
Z. Brzoza ◽  
L. Brzezińska-Wcisło
Keyword(s):  
Body Mass Index ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface

scholarly journals Impact of Age, Body Surface Area, and Body Mass Index on Pegaspargase Toxicity and Pharmacokinetics: A Report from the DFCI ALL Consortium

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3396-3396
Author(s):  
Jonathan D. Paolino ◽  
Yael Flamand ◽  
Kristen E. Stevenson ◽  
Victoria Koch ◽  
Uma H. Athale ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Older Patients ◽  
Time Points ◽  
Induction Dose ◽  
Post Induction ◽  
The Impact

Abstract Introduction: Increased toxicity with pegaspargase (PEG) in older and higher body mass index (BMI) patients (pts) with acute lymphoblastic leukemia (ALL) has recently led to dose capping practices. We assessed the influence of age, body surface area (BSA), and BMI on PEG-related toxicity and pharmacokinetics from two consecutive DFCI ALL Consortium trials without dose capping. Methods: Patient (pts) aged 1 to &lt;19 years (DFCI 05-001) or 1 to &lt;22 years (DFCI 11-001) with newly diagnosed ALL were eligible for enrollment. Those who received PEG (2500 IU/m 2) were included in this analysis. Pts received 1 dose of IV PEG on day 7 of Induction and every 2 weeks for 15 doses post-induction. Serum asparaginase activity (SAA), considered therapeutic at &gt;0.1 IU/mL, was assessed 4, 11, 18, and 25 days after the Induction dose and nadir SAA was assessed before each Post-Induction dose. Asparaginase-related toxicities were prospectively assessed and graded by CTCAE version 3.0 (DFCI 05-001) or 4.0 (DFCI 11-001). Asparaginase toxicity for this analysis was defined as ≥1 of the following: pancreatitis, thrombosis, ≥grade 4 hyperbilirubinemia, ≥grade 4 hypertriglyceridemia. Allergy was analyzed separately (due to presumed dose independence). Height and weight at diagnosis were used for analyses. BMI categories were assigned using standard percentile ranges based on gender specific 2000 CDC growth charts. BSA was calculated using the Mosteller formula. Univariate analyses evaluated the relationship of age, BMI, and BSA with asparaginase toxicity. Comparisons of toxicity across BMI and BSA categories were performed using a Jonckheere-Terpstra test. Categorical comparisons for dichotomized BMI and BSA utilized a Fisher's exact test or chi square test. The relationships between BMI and BSA with toxicity were explored using multivariable models. Results: Between 4/2005-12/2011 802 pts enrolled on DFCI 05-001 and between 6/2012-6/2015 240 pts enrolled on DFCI 11-001. Both trials included random assignment of asparaginase formulation. In total 911 patients received pegaspargase during Induction and 351 during Post-Induction. During Induction, pts ≥15 years of age had higher asparaginase toxicity rates (17.1% vs 6.2%, p=0.0003) (Figure 1a). Toxicity differed significantly across BSA categories (&lt;1.5 m 2, 1.5 to &lt;2.0 m 2, ≥2.0 m 2, p= 0.007) with increased toxicity in those with BSA ≥2.0m 2 (22.7% vs. 6.8% for those &lt;2.0 m 2, p = 0.016) (Figure 1b). Age was highly correlated with BSA (Pearson r = 0.93, p &lt;0.0001). There was numerically higher toxicity in the BMI category of overweight vs. those underweight or normal weight (11.3% vs 6.5%) however this did not extend to the obese category, and overall, increasing BMI was not associated with statistically higher toxicity (p= 0.13, Figure 1c). Post-Induction, age ≥15 years was associated with increased asparaginase toxicity (57.1% vs 21%, p&lt;0.0001) (Figure 1d). Toxicity differed significantly across BSA categories (p&lt;0.0001) but was similar between BMI categories (p=0.19, Figure 1e-f). The impact of BSA was observed when dichotomized at thresholds of 1.5m 2 (54% vs. 19%, p&lt;0.0001) and 2.0m 2 (70% vs. 23%, p=0.003) (Figure 1e). Considering only those ≥10 years of age, trends for BSA/BMI and toxicity were similar. There was no significant association between BMI or BSA and allergy. In multivariable analysis, BSA was a significant predictor of Post-Induction toxicity (OR 4.21, p&lt;0.0001). Age was significant in the univariate setting (OR 1.14, p&lt;0.0001) however due to high correlation with BSA, was not included with BSA in the multivariable model. Post-Induction, median nadir SAA levels were ≥0.1IU/mL for all BSA and age categories. Median SAA was similar or lower at all time-points for those ≥15 years of age compared with younger children. Median SAA for pts with BSA ≥1.5m 2 were similar or lower compared to those with BSA &lt;1.5m 2 (Figure 2a-d). Conclusion: Age ≥15 years and BSA ≥2m 2 were each associated with significantly increased asparaginase toxicity. Older patients and those with higher BSA had similar or lower median SAA levels at all time-points. These results suggest that the differential toxicity seen in older patients and those with higher BSA is not explained by these patients having higher SAA levels. Prospective exploration of interventions to decrease toxicity in older patients and those with high BSA are needed. Figure 1 Figure 1. Disclosures Neuberg: Madrigal Pharmaceuticals: Other: Stock ownership; Pharmacyclics: Research Funding. Silverman: Takeda, Servier, Syndax, Jazz Pharmaceuticals: Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees.

scholarly journals Evaluation of Natalizumab Pharmacokinetics and Pharmacodynamics: Toward Individualized Doses

2021 ◽  
Vol 12 ◽  
Author(s):  
Jose M. Serra López-Matencio ◽  
Yaiza Pérez García ◽  
Virginia Meca-Lallana ◽  
Raquel Juárez-Sánchez ◽  
Angeles Ursa ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Plasma Concentration ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Treatment Duration ◽  
Pharmacokinetics And Pharmacodynamics ◽  
The Impact

Background: Plasma concentration of natalizumab falls above the therapeutic threshold in many patients who, therefore, receive more natalizumab than necessary and have higher risk of progressive multifocal leukoencephalopathy.Objective: To assess in a single study the individual and treatment characteristics that influence the pharmacokinetics and pharmacodynamics of natalizumab in multiple sclerosis (MS) patients in the real-world practice.Methods: Prospective observational study to analyse the impact of body weight, height, body surface area, body mass index, gender, age, treatment duration, and dosage scheme on natalizumab concentrations and the occupancy of α4-integrin receptor (RO) by natalizumab.Results: Natalizumab concentrations ranged from 0.72 to 67 μg/ml, and RO from 26 to 100%. Body mass index inversely associated with natalizumab concentration (beta = −1.78; p ≤ 0.001), as it did body weight (beta = −0.34; p = 0.001), but not height, body surface area, age or gender Extended vs. standard dose scheme, but not treatment duration, was inversely associated with natalizumab concentration (beta = −7.92; p = 0.016). Similar to natalizumab concentration, body mass index (beta = −1.39; p = 0.001) and weight (beta = −0.31; p = 0.001) inversely impacted RO. Finally, there was a strong direct linear correlation between serum concentrations and RO until 9 μg/ml (rho = 0.71; p = 0.003). Nevertheless, most patients had higher concentrations of natalizumab resulting in the saturation of the integrin.Conclusions: Body mass index and dosing interval are the main variables found to influence the pharmacology of natalizumab. Plasma concentration of natalizumab and/or RO are wide variable among patients and should be routinely measured to personalize treatment and, therefore, avoid either over and underdosing.

Sign in / Sign up

Export Citation Format

Share Document