New Reference Centiles for Left Ventricular Mass Relative to Lean Body Mass in Children
New Reference Centiles for Left Ventricular Mass Relative to Lean Body Mass in Children
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DOI：
10.1016/j.echo.2015.12.011
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发表时间：
2016-05-01
影响因子：
6.5
通讯作者：
Mitsnefes, Mark
中科院分区：
文献类型：
--
作者：
Foster, Bethany J.;Khoury, Philip R.;Mitsnefes, Mark
背景：超声心动图测量左心室（LV）质量是心血管风险升高的儿科患者的常规检查方法。儿童心脏生长与身体生长之间的复杂关系需要对左室质量进行规范化，以确定其相对于身体大小的适宜性。左室质量在很大程度上取决于瘦体重（LBM）。利用新的LBM预测方程，研究人员为5至18岁的儿童生成了性别特异性的LBM质量百分位曲线。方法：本回顾性研究使用1995年至2003年收集的939名5 - 18岁男孩和771名女孩的m型超声心动图数据（性别和年龄的体重指数< 85百分位数），使用Lamda Mu Sigma方法创建平滑的性别特异性左室质量与lbm参考百分位数曲线。新开发的参考百分位数应用于患有原发性高血压和慢性肾脏疾病的儿童，这些人群已知是左室肥大（LVH）的高危人群。采用两种不同的归一化方法对LVH的识别进行比较：LV质量- lbm和LV质量指数-年龄百分位数。结果：在231名LVH高危儿童中，平均而言，使用年龄级LVH质量指数百分位数法的相对LVH质量高于使用lbm百分位数法的相对LVH质量。超重儿童更容易被诊断出LVH，而瘦弱儿童则不太可能。结论：本研究提供了新的左室质量参考百分位数，表示左室相对于左室的质量，这是左室质量的最强决定因素。这些参考百分位数可以使儿童心血管风险的分层更加准确。
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.