LEFT-VENTRICULAR MASS AND BODY SIZE IN NORMOTENSIVE CHILDREN AND ADULTS - ASSESSMENT OF ALLOMETRIC RELATIONS AND IMPACT OF OVERWEIGHT
LEFT-VENTRICULAR MASS AND BODY SIZE IN NORMOTENSIVE CHILDREN AND ADULTS - ASSESSMENT OF ALLOMETRIC RELATIONS AND IMPACT OF OVERWEIGHT
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DOI：
10.1016/0735-1097(92)90385-z
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发表时间：
1992-11-01
影响因子：
24
通讯作者：
ALDERMAN, MH
中科院分区：
文献类型：
--
作者：
DESIMONE, G;DANIELS, SR;ALDERMAN, MH
目标.本研究旨在确定最合适的方法来标准化左心室质量的身体尺寸。在实验和临床研究中，左心室质量已被标准化为体重，表面积或身高，但它是不确定的，这些方法是最合适的。通过超声心动图研究了三个血压正常的人群样本--纽约市（127名成人）、意大利那不勒斯（114名成人）和俄亥俄州辛辛那提（444名婴儿至年轻人）。通过线性和非线性回归分析，所有正常体重组的左心室质量与体型的关系相似，并将结果合并（n = 611）。左心室质量与体重呈一次幂相关（r = 0.88），与体表面积的1.5次方（r = 0.88）和身高的2.7次方（r = 0.84），与预期的异速生长（生长）关系的变量与线性（身高），二次幂（体表面积）和体积（左心室质量和体重）尺寸。左心室质量/体表面积与体表面积（r = 0.54）和心室质量/身高与身高（r = 0.72）的强残差关系通过心室质量对身高2.7和体表面积1.5的标准化显著降低。通过体重、体表面积、体表面积1.5或身高2.7的标准化，心室质量的受试者之间的变异性也降低了（p < 0.01至p < 0.002），但身高没有。在20%超重的成年人中，心室质量高出14（p < 0.001）高于根据观察身高和理想体重预测的理想体重;这种增加通过左心室质量/高度2.7确定为14%，通过心室质量/高度2.7确定为9%，而对于体表面积，体表面积1.5和体重错误地将超重成人的左心室质量识别为减少。左心室质量相对于身高或体表面积的标准化引入了心室质量指数与身体尺寸的人为关系以及估计超重影响的错误。使用左心室质量/高度2.7可以避免这些问题，并降低正常受试者之间的变异性。身高和左心室质量之间正常关系的简单列线图可以检测儿童和成人的心室肥大。
Objectives. This study was designed to determine the most appropriate method to normalize left ventricular mass for body size.Background. Left ventricular mass has been normalized for body weight, surface area or height in experimental and clinical studies, but it is uncertain which of these approaches is most appropriate.Methods. Three normotensive population samples-in New York City (127 adults), Naples, Italy (114 adults) and Cincinnati, Ohio (444 infants to young adults)-were studied by echocardiography. Relations of left ventricular mass to body size were similar in all normal weight groups, as assessed by linear and nonlinear regression analysis, and results were pooled (n = 611).Results. Left ventricular mass was related to body weight to the first power (r = 0.88), to body surface area to the 1.5 power (r = 0.88) and to height to the 2.7 power (r = 0.84), consistent with expected allometric (growth) relations between variables with linear (height), second-power (body surface area) and volumetric (left ventricular mass and body weight) dimensions. Strong residual relations of left ventricular mass/body surface area to body surface area (r = 0.54) and of ventricular mass/height to height (r = 0.72) were markedly reduced by normalization of ventricular mass for height2.7 and body surface area1.5. The variability among subjects of ventricular mass was also reduced (p < 0.01 to p < 0.002) by normalization for body weight, body surface area, body surface area1.5 or height2.7 but not for height. In 20% of adults who were overweight, ventricular mass was 14% higher (p < 0.001) than ideal mass predicted from observed height and ideal weight; this increase was identified as 14% by left ventricular mass/height2.7 and 9% by ventricular mass/height, whereas indexation for body surface area, body surface area1.5 and body weight erroneously identified left ventricular mass as reduced in overweight adults.Conclusions. Normalizations of left ventricular mass for height or body surface area introduce artifactual relations of indexed ventricular mass to body size and errors in estimating the impact of overweight. These problems are avoided and variability among normal subjects is reduced by using left ventricular mass/height2.7. Simple nomograms of the normal relation between height and left ventricular mass allow detection of ventricular hypertrophy in children and adults.