Indexation of left ventricular mass to body surface area and height to allometric power of 2.7: is the difference limited to obese hypertensives?
Indexation of left ventricular mass to body surface area and height to allometric power of 2.7: is the difference limited to obese hypertensives?
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DOI：
10.1038/jhh.2009.16
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发表时间：
2009-11-01
影响因子：
2.7
通讯作者：
Mancia, G.
中科院分区：
文献类型：
--
作者：
Cuspidi, C.;Meani, S.;Mancia, G.
左心室质量（LVM）是否应该归一化为与体型相关的不同指标仍存在争议。我们试图评估根据身体质量指数（BMI）分类的高血压患者队列中不同指标标准定义的左心室肥厚（LVH）的患病率。纳入高血压靶器官损害评价（ETODH）的2213例原发性高血压患者按BMI阈值（= 30 kg m(-2)）分为三组。所有患者都进行了广泛的调查，包括定量超声心动图。LVH被定义为LVM指数等于或大于(1)男性125 g m(-2)，女性110 g m(-2)，男性51 g m(-2.7)，女性47 g m（-2.7）。总的来说，2213例患者中，当LVM与体表面积（BSA）挂钩时，发现有687例（31.0%）LVH，当LVM与身高（2.7）挂钩时，发现有1030例（46.5%）LVH。BMI正常845例（38.2%），超重954例（43.1%），肥胖414例（18.7%）。三组LVH的BSA指数分别为25.1%、31.6、41.2%，身高指数分别为29.9%、50.5、71.8%（2.7）。以BSA为指标的LVM明显低估了肥胖和超重高血压患者的LVH患病率。为了避免心血管风险的系统性错误分类，对于占高血压人群很大比例的超重和肥胖患者，LVM应常规与身高（2.7）挂钩。人类高血压杂志（2009）23,728-734；doi: 10.1038 / jhh.2009.16;2009年3月26日在线发布
Whether left ventricular mass (LVM) should be normalized to different indexes in relation to body size is still debated. We sought to evaluate the prevalence of left ventricular hypertrophy (LVH) defined by different indexation criteria in a cohort of hypertensive subjects categorized according to body mass index (BMI). A total of 2213 essential hypertensive subjects included in the Evaluation of Target Organ Damage in Hypertension (ETODH) were divided in three groups according to BMI thresholds (= 30 kg m(-2)). All patients underwent extensive investigations including quantitative echocardiography. LVH was defined as an LVM index equal to or higher than (1) 125 g m(-2) in men and 110 g m(-2) in women, (2) 51 g m(-2.7) in men and 47 g m(-2.7) in women. Overall, 687 out of 2213 patients (31.0%) were found to have LVH when LVM was indexed to body surface area (BSA) and 1030 (46.5%) when indexed to height(2.7). A total of 845 patients (38.2%) had normal BMI, 954 patients (43.1%) were overweight and 414 (18.7%) were obese. Prevalence rates of LVH in the three groups were 25.1, 31.6, 41.2% by indexation to BSA and 29.9, 50.5, 71.8% by indexation to height(2.7), respectively. LVM indexed to BSA markedly underestimates LVH prevalence in obese as well as overweight hypertensive patients. To avoid a systematic misclassification of cardiovascular risk, LVM should be routinely indexed to height(2.7) in overweight and obese patients representing a large percentage of the hypertensive population. Journal of Human Hypertension (2009) 23, 728-734; doi: 10.1038/jhh.2009.16; published online 26 March 2009