Does size matter? Clinical applications of scaling cardiac size and function for body size
Does size matter? Clinical applications of scaling cardiac size and function for body size
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DOI：
10.1161/circulationaha.107.736785
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发表时间：
2008-04-29
期刊：
影响因子：
37.8
通讯作者：
Ashley, Euan A.
中科院分区：
文献类型：
--
作者：
Dewey, Frederick E.;Rosenthal, David;Ashley, Euan A.
大量证据表明，心血管结构和功能，以及跨越生物体大小和物种形成范围的其他生物学特性，与身体大小成比例。尽管对这些因素的认识在儿科中很常见，但成年人的心血管测量由于体型的差异也很大，因此很少根据体型进行校正。在这篇综述中，我们描述了身体尺寸测量在心血管医学中的关键作用。我们通过例子来说明体型的混杂影响。回顾了当前的心血管尺度实践，以及身体和心血管维度之间的局限性和替代关系。介绍了各种功能参数缩放的实验证据、理论基础和临床应用。适当缩放的参数有助于在肥厚性心肌病和充血性心力衰竭等特定疾病状态下做出诊断和治疗决策。为此需要对临床人群进行大规模研究来定义规范关系。在评估心血管结构和功能时缺乏对体型的适当考虑可能会对成年患者心血管疾病状态的识别和治疗产生不利影响。
Extensive evidence is available that cardiovascular structure and function, along with other biological properties that span the range of organism size and speciation, scale with body size. Although appreciation of such factors is commonplace in pediatrics, cardiovascular measurements in the adult population, with similarly wide variation in body size, are rarely corrected for body size. In this review, we describe the critical role of body size measurements in cardiovascular medicine. Using examples, we illustrate the confounding effects of body size. Current cardiovascular scaling practices are reviewed, as are limitations and alternative relationships between body and cardiovascular dimensions. The experimental evidence, theoretical basis, and clinical application of scaling of various functional parameters are presented. Appropriately scaled parameters aid diagnostic and therapeutic decision making in specific disease states such as hypertrophic cardiomyopathy and congestive heart failure. Large-scale studies in clinical populations are needed to define normative relationships for this purpose. Lack of appropriate consideration of body size in the evaluation of cardiovascular structure and function may adversely affect recognition and treatment of cardiovascular disease states in the adult patient.