Left Ventricular Mass Indexing in Infants, Children, and Adolescents: A Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical Practice

Chinali, Marcello; Emma, Francesco; Esposito, Claudia; Rinelli, Gabriele; Franceschini, Alessio; Doyon, Anke; Raimondi, Francesca; Pongiglione, Giacomo; Schaefer, Franz; Matteucci, Maria Chiara

doi:10.1016/j.jpeds.2015.10.085

Cited by 72 publications

(67 citation statements)

References 27 publications

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“…We also found that in 6-year-old children LBM has the strongest independent association with LVM. Similar results have been reported previously, with some authors advocating indexing LVM for varying exponents of height [19,28] in the paediatric population. However, previous studies have also provided evidence that body adiposity has an additional impact on LVM in children and adolescents [7].…”

Section: Discussionsupporting

confidence: 90%

Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up

et al. 2019

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Aim To investigate the influence of maternal adiposity and gestational diabetes on offspring body composition and left ventricle mass in early childhood. Methods The observational follow‐up study included 201 mother‐child pairs, a sub‐cohort from the Finnish Gestational Diabetes Prevention Study, who were recruited 6.1 ± 0.5 (mean ± SD) years postpartum, aiming for an equal number of mothers with and without gestational diabetes. Results Maternal pre‐pregnancy BMI (mean ± SD; 30.5 ± 5.6 kg/m2) was associated with child body fat percentage [0.26 (95% CI; 0.08, 0.44)% increase in child body fat per 1 kg/m2 increase in pre‐pregnancy BMI of mothers with obesity] and was reflected in child BMI Z‐score (mean ± SD; 0.45 ± 0.93). Left ventricle mass, left ventricle mass index and left ventricle mass Z‐score were not associated with gestational diabetes, pre‐pregnancy BMI or child body fat percentage. After adjusting for child sex, body fat percentage, systolic blood pressure, pre‐pregnancy BMI and maternal lean body mass, left ventricle mass increased by 3.08 (95% CI; 2.25, 3.91) g for each 1 kg in child lean body mass. Conclusions Left ventricle mass at 6 years of age is determined predominantly by lean body mass. Maternal pre‐gestational adiposity is reflected in child, but no direct association between left ventricle mass and child adiposity or evidence of left ventricle mass foetal programming related to gestational diabetes and maternal adiposity was observed in early childhood.

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Section: Discussionsupporting

confidence: 90%

Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up

et al. 2019

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“…Left ventricular mass and the left ventricular mass index (LVMI) were calculated. LVMI >45 g/m 2 was classified as left ventricular hypertrophy …”

Section: Methodsmentioning

confidence: 99%

High Burden of Subclinical Cardiovascular Target Organ Damage After Pediatric Liver Transplantation

et al. 2019

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Cardiovascular (CV) events account for 8%‐13% of deaths after liver transplantation (LT) in adulthood. Although CV risk factors (RFs) are present, little is known about the prevalence of subclinical CV target organ damage (TOD) in children after LT. The aim of this prospective observational study was to assess the prevalence of subclinical CV TOD in children after LT and to identify RFs contributing to CV damage as potential targets for clinical intervention. In this study, 104 children after LT (54% female, 46% male; aged 11.5 ± 3.8 years) underwent cross‐sectional assessment of subclinical TOD by carotid‐femoral pulse wave velocity (PWV), carotid intima‐media thickness (IMT), and left ventricular mass index (LVMI). Results were correlated with the presence of CV RFs (obesity, hypertension, dyslipidemia, renal impairment, anemia, and microinflammation). Of the patients, 22% were exposed to 2 CV RFs, and 36% displayed 3 or more CV RFs. Pathological results for PWV, IMT, and LVMI were found in 21.9%, 57.0%, and 11.1% of patients, respectively. In the multivariate analysis, diastolic blood pressure (P = 0.01) and estimated glomerular filtration rate (eGFR; P = 0.03) were independently associated with PWV, eGFR (P = 0.005), and age at LT (P = 0.048) with IMT and body mass index with LVMI (P = 0.004). In conclusion, patients after pediatric LT carry a substantial burden of subclinical CV TOD. Identification of modifiable CV RFs opens opportunities for targeted intervention in order to reduce CV morbidity and mortality in the future.

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“…LVM was calculated according to the Devereux formula [13] and analyzed as both unindexed as well as indexed to the allometric power of height (m) 2.16 + 0.09 [14]. To define LV hypertrophy, age-specific partition values were applied as previously reported by our group [14]. For the identification of concentricity of LV remodeling, myocardial thickness (wall + septum) was divided by the LV minor axis (diameter) to generate a relative wall thickness (RWT).…”

Section: Methodsmentioning

confidence: 99%

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

et al. 2019

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Background: No previous study has defined the prevalence of cardiac geometric and mechanical function abnormalities through the analysis of advanced echocardiographic parameters in children with autosomal recessive polycystic kidney disease (ARPKD). Aim: The purpose of this study was to evaluate cardiac geometry and function through advanced echocardiography in a well-characterized sample of pediatric patients with ARPKD. Methods: Standard echocardiograms were obtained in 27 children with ARPKD (0–18 years) and in 88 healthy children of similar age, gender distribution, and body build. Left ventricular (LV) hypertrophy was defined as LV mass > 45g/(m^2.16 + 0.09) and cardiac remodeling was defined by age-adjusted relative wall thickness (RWT). Systolic function was assessed by ejection fraction, midwall fractional shortening (mFS), and global longitudinal (GLS) and circumferential strain (GCS). Results: Patients with ARPKD exhibited a higher LV mass index as compared to controls, and a more concentric LV geometry (both p < 0.001). Accordingly, the prevalence of abnormal LV geometry was significantly higher in ARPKD (33 vs. 0%; p < 0.005). No differences could be observed in the two groups for ejection fraction or GLS (both p = n.s.), while a significantly lower mFS (p < 0.05) as well as GCS (p < 0.001) could be observed. In the analysis of covariance, both LV mass index and RWT remained significantly higher in the ARPKD group, while mFS and GCS remained significantly lower (all p < 0.05). The prevalence of subclinical systolic dysfunction was significantly higher in patients with ARPKD as compared with control subjects (33 vs. 0%; p < 0.001). Conclusions: Children with ARPKD show significantly impaired cardiac phenotype, characterized by high rates of LV abnormal geometry paired with systolic mechanical dysfunction.

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Left Ventricular Mass Indexing in Infants, Children, and Adolescents: A Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical Practice

Cited by 72 publications

References 27 publications

Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up

Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up

High Burden of Subclinical Cardiovascular Target Organ Damage After Pediatric Liver Transplantation

Cardiac Abnormalities in Children with Autosomal Recessive Polycystic Kidney Disease

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