Left ventricular mass by echocardiographic measures in children and adolescents.

Background: Recent evidence in adults suggests that left ventricular mass measured as left ventricular mass/height predicts cardiovascular morbidity and mortality better than the two widely used indices, left ventricular mass/body surface area and left ventricular mass/height Standards of left ventricular mass/height 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.

Methods: In 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/height, left ventricular mass/body surface area, and left ventricular mass/height--are associated with obesity as measured by body mass index. Correlations, t-tests, and linear regressions were used for statistical testing.

Results: Left ventricular mass/height was better correlated (R2 = 0.36) with body mass index than left ventricular mass/body surface area (R2 = 0.179) and left ventricular mass/height (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/height than by the other two methods.

Conclusions: Left ventricular mass/height is a reliable indicator of obesity associated left ventricular hypertrophy. Left ventricular mass/height 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/height in future studies of cardiovascular risks and preventive strategies in children and adolescents.