Effect of Lean Body Mass, Fat Mass, Blood Pressure, and Sexual Maturation on Left Ventricular Mass in Children and Adolescents

AbstractObjective:Cardiovascular morbidity is high in patients with coarctation of aorta even after successful repair. This study aimed to assess the frequency of late hypertension and the relationship between ambulatory hypertension and cardiovascular target organ damage in children and adolescents after early and successful repair of coarctation of the aorta.Methods:Twenty-five children and adolescents (mean age 13.5 ± 3.43 years) with repaired coarctation of the aorta (median age at repair 4 months, arm–leg gradient <20 mmHg) and 16 healthy controls were included. Office and ambulatory blood pressure, pulse wave velocity, and left ventricular mass index were assessed.Results:Both day- and night-time systolic blood pressure standard deviation score and left ventricular mass index were significantly higher in patients compared to controls (p ≤ 0.001 for all), whereas pulse wave velocity did not differ. The prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy were 40, 28, and 24%, respectively. Left ventricular mass index was higher in patients with sustained hypertension, masked hypertension, and normotension compared to controls (p < 0.05). In multivariate analysis, higher night-time systolic blood pressure standard deviation score was the only independent predictor of left ventricular mass index.Conclusion:The present study reveals a high prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy in children and adolescents with coarctation of the aorta even after early and successful repair. Ambulatory blood pressure monitoring should be considered to diagnose hypertension. All coarctation of aorta patients should be followed up lifelong and encouraged to establish a healthy lifestyle starting from childhood.

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Left ventricular mass by echocardiographic measures in children and adolescents

Cardiology in the Young ◽

10.1017/s1047951112001862 ◽

2012 ◽

Vol 23 (5) ◽

pp. 727-737 ◽

Cited By ~ 2

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.

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

Cardiology in the Young ◽

10.1017/s1047951120000311 ◽

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.

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Effect of haemodynamic and metabolic predictors on echocardiographic left ventricular mass in non-diabetic hypertensive patients

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i2.3553 ◽

1970 ◽

Vol 8 (2) ◽

pp. 173-178

Author(s):

N Gupta ◽

P Karki ◽

S Sharma ◽

N Shrestha ◽

P Acharya

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Stroke Volume ◽

Left Ventricular Mass ◽

Body Mass ◽

Left Ventricular ◽

Metabolic Factors ◽

Hypertensive Patients ◽

Ventricular Mass ◽

Lv Mass

Background: Left ventricular hypertrophy is a forerunner of coronary heart disease, congestive cardiac failure, stroke and may also lead to sudden death. Estimation of left ventricular mass by echocardiography offers prognostic information better than the evaluation of traditional cardiovascular risk factors. Objective: The aim of this study was to determine the relative contributions of haemodynamic and metabolic factors affecting left ventricular mass in non-diabetic patients with essential hypertension. Material and methods: 100 non-diabetic hypertensive patients were taken. The association between age, gender, smoking, alcohol, height, weight, heart rate, clinic blood pressure, fasting blood glucose, lipid profile, haemoglobin, body mass index and stroke volume with LV mass was studied. Left ventricular mass was measured by using standard M-mode echocardiography measurement obtained by way of standard recommended by the American Society of Echocardiography. Results: Left ventricular mass was analyzed as a continuous variable. In males body mass index (r=.35, p<.004) and stroke volume(r=-.26, p<.039) were significantly correlated with LV mass. In females body weight was significantly related to left ventricular mass(r=.36, p<.02). The independent association between significant factors and left ventricular mass was assessed by stepwise multivariate logistic regression. Body mass index and systolic blood pressure came as independent determinants of left ventricular mass in all patients. A maximum of 13% of left ventricular mass variability could be explained by these two factors. Conclusion: In untreated patients with hypertension patient's body mass index and systolic blood pressure are independent predictors of left ventricular mass after adjustment for other haemodynamic and metabolic factors. They explain a maximum of 13% of left ventricular mass variability. More knowledge is needed about factors that may alter cardiac morphology in the evolution of hypertensive patients. Key words: Echocardiography; Haemodynamic; Metabolic Factors; Left Ventricular Mass; Non-diabetic; Hypertensive DOI: 10.3126/kumj.v8i2.3553 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 173-178

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Left Ventricular Mass in Children and Adolescents With Elevated Body Mass Index and Normal Waist Circumference

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.11.068 ◽

2014 ◽

Vol 113 (6) ◽

pp. 1054-1057 ◽

Cited By ~ 8

Author(s):

Sudhir Ken Mehta

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Children And Adolescents ◽

Left Ventricular Mass ◽

Body Mass ◽

Left Ventricular ◽

Elevated Body Mass Index ◽

Ventricular Mass

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Anger Types: Heritability and Relation to Blood Pressure, Body Mass Index, and Left Ventricular Mass

Journal of Clinical Hypertension ◽

10.1111/j.1751-7176.2008.00011.x ◽

2008 ◽

Vol 10 (9) ◽

pp. 700-706 ◽

Cited By ~ 3

Author(s):

Lillian Gleiberman ◽

Tiffany A. Greenwood ◽

Amy Luke ◽

Maria C. Delgado ◽

Alan B. Weder

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Left Ventricular Mass ◽

Body Mass ◽

Left Ventricular ◽

Ventricular Mass

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INFLUENCE OF LEAN BODY MASS AND PHYSICAL ACTIVITY ON LEFT VENTRICULAR MASS IN A PHYSICALLY ACTIVE POPULATION 434

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199605001-00434 ◽

1996 ◽

Vol 28 (Supplement) ◽

pp. 73

Author(s):

L. Magnus ◽

J. Roeykens ◽

P. Dendale ◽

K. De Meirleir

Keyword(s):

Physical Activity ◽

Left Ventricular Mass ◽

Lean Body Mass ◽

Body Mass ◽

Left Ventricular ◽

Physically Active ◽

Active Population ◽

Ventricular Mass

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Relationship between Plasma Aldosterone Levels and Left Ventricular Mass in Hypertensive Africans

International Journal of Hypertension ◽

10.1155/2013/762597 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Adewole Adebiyi ◽

Olubayo Akinosun ◽

Chibuike Nwafor ◽

Ayodele Falase

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Left Ventricular Mass ◽

Body Mass ◽

Plasma Renin ◽

Left Ventricular ◽

Plasma Aldosterone ◽

The Body ◽

Ventricular Mass ◽

Lv Mass

Background.Hypertension is the most common cardiovascular disease worldwide and is a major cause of morbidity and mortality. Studies have suggested that the activity of the renin-angiotensin-aldosterone system play a major role in the target organ damage such as left ventricular hypertrophy occuring in hypertension. We sought to determine the relationship between plasma aldosterone and left ventricular mass in untreated African hypertensives.Methods.We recruited 82 newly diagnosed and untreated hypertensives and 51 normal controls. Measurements obtained included echocardiographic LV mass index, plasma aldosterone and renin.Results.The hypertensive subjects had lower renin levels (21.03[6.974] versus 26.66[7.592] ng.mL−1,P=0.0013), higher LV mass index (52.56[14.483] versus 42.02[8.315] g.m−2.7P<0.0001) when compared with the controls. There were no univariate associations between LV mass index and plasma aldosterone (r=0.0179,P=0.57) and between LV mass index and plasma renin (r=0.0887,P=0.61). In a multivariate model involving LV mass index and age, sex, body mass index (BMI), plasma aldosterone, plasma renin and systolic blood pressure (SBP), only age (P=0.008), BMI (P=0.046), and SBP (P=0.001) were independently associated with the LV mass index.Conclusions. In this group of hypertensive Africans, there is no independent association of plasma aldosterone with LV mass. The height of the blood pressure, the body mass index and the age of the subjects determined the LV mass.

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