Bethany J Foster1, Philip R Khoury2, Thomas R Kimball2, Andrew S Mackie3, Mark Mitsnefes4. 1. Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Faculty of Medicine, Montreal, Quebec, Canada. Electronic address: bethany.foster@mcgill.ca. 2. Department of Pediatrics, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. Department of Pediatrics, Division of Cardiology, Stollery Children's Hospital, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 4. Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Abstract
BACKGROUND: Echocardiographic measurement of left ventricular (LV) mass is routinely performed in pediatric patients with elevated cardiovascular risk. The complex relationship between heart growth and body growth in children requires normalization of LV mass to determine its appropriateness relative to body size. LV mass is strongly determined by lean body mass (LBM). Using new LBM predictive equations, the investigators generated sex-specific LV mass-for-LBM centile curves for children 5 to 18 years of age. METHODS: This retrospective study used M-mode echocardiographic data collected from 1995 through 2003 from 939 boys and 771 girls between 5 and 18 years of age (body mass index < 85th percentile for sex and age) to create smoothed sex-specific LV mass-for-LBM reference centile curves using the Lamda Mu Sigma method. The newly developed reference centiles were applied to children with essential hypertension and with chronic kidney disease, groups known to be at high risk for LV hypertrophy (LVH). The identification of LVH using two different normalization approaches was compared: LV mass-for-LBM and LV mass index-for-age percentiles. RESULTS: Among 231 children at risk for LVH, on average, relative LV mass was higher using the LV mass index-for-age percentile method than the LV mass-for-LBM percentile method. LVH was more likely to be diagnosed among overweight children and less likely among thin children. CONCLUSIONS: This study provides new LV mass reference centiles expressing LV mass relative to LBM, the strongest determinant of LV mass. These reference centiles may allow more accurate stratification of cardiovascular risk in children.
BACKGROUND: Echocardiographic measurement of left ventricular (LV) mass is routinely performed in pediatric patients with elevated cardiovascular risk. The complex relationship between heart growth and body growth in children requires normalization of LV mass to determine its appropriateness relative to body size. LV mass is strongly determined by lean body mass (LBM). Using new LBM predictive equations, the investigators generated sex-specific LV mass-for-LBM centile curves for children 5 to 18 years of age. METHODS: This retrospective study used M-mode echocardiographic data collected from 1995 through 2003 from 939 boys and 771 girls between 5 and 18 years of age (body mass index < 85th percentile for sex and age) to create smoothed sex-specific LV mass-for-LBM reference centile curves using the Lamda Mu Sigma method. The newly developed reference centiles were applied to children with essential hypertension and with chronic kidney disease, groups known to be at high risk for LV hypertrophy (LVH). The identification of LVH using two different normalization approaches was compared: LV mass-for-LBM and LV mass index-for-age percentiles. RESULTS: Among 231 children at risk for LVH, on average, relative LV mass was higher using the LV mass index-for-age percentile method than the LV mass-for-LBM percentile method. LVH was more likely to be diagnosed among overweight children and less likely among thin children. CONCLUSIONS: This study provides new LV mass reference centiles expressing LV mass relative to LBM, the strongest determinant of LV mass. These reference centiles may allow more accurate stratification of cardiovascular risk in children.
Authors: Rebecca L Ruebner; Derek Ng; Mark Mitsnefes; Bethany J Foster; Kevin Meyers; Bradley Warady; Susan L Furth Journal: Clin J Am Soc Nephrol Date: 2016-09-14 Impact factor: 8.237
Authors: Swati Choudhry; Amber Salter; Tyler W Cunningham; Philip T Levy; Hoang H Nguyen; Michael Wallendorf; Gautam K Singh; Mark C Johnson Journal: J Am Soc Echocardiogr Date: 2017-06-07 Impact factor: 5.251
Authors: Andrea Kelly; Samuel S Gidding; Rachel Walega; Claire Cochrane; Sarah Clauss; Ray R Townsend; Melissa Xanthopoulos; Mary E Pipan; Babette S Zemel; Sheela N Magge; Meryl S Cohen Journal: Pediatr Cardiol Date: 2018-11-01 Impact factor: 1.655