Left ventricular mass is underestimated in overweight children because of incorrect body size variable chosen for normalization

Krysztofiak, Hubert; Młyńczak, Marcel; Małek, Łukasz A.; Folga, Andrzej; Braksator, Wojciech

doi:10.1371/journal.pone.0217637

Cited by 8 publications

(10 citation statements)

References 42 publications

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“…It is consistent with the results of our previous studies [17,18], and the presence of a significant relationship between LVM indexed to height raised to the power of 2.7 and height in girls additionally confirms the results of the current work.…”

Section: Plos Onesupporting

confidence: 93%

“…To diagnose or manage LVH, actual LVM normalized for body size has to be compared to properly developed normative data. In our recent studies, we analyzed a problem of the correct body size variable for cardiac LVM normalization [17] and the issue of an accurate and convenient method for cardiac size scaling [18]. In previous studies, we developed normative data for children and adolescents practicing sport and compared them to the normative data generated for the general pediatric population [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Left ventricular mass normalization in child and adolescent athletes must account for sex differences

et al. 2020

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Background To assess left ventricular hypertrophy, actual left ventricular mass (LVM) normalized for body size has to be compared to the LVM normative data. However, only some published normative echocardiographic data have been produced separately for girls and boys; numerous normative data for the pediatric population are not sex-specific. Thus, this study aimed to assess whether the LVM normative data should be developed separately for girls and boys practicing sports. Methods Left ventricular mass was computed for 331 girls and 490 boys, 5-19 years old, based on echocardiography. The effect of sex on the relationship between LVM and body size was evaluated using a linear regression model. Seven sets of the LVM normative data were developed, using different methodologies, to test concordance between sex-specific and non-specific normative data. Every set consisted of normative data that was sex-specific and non-specific. Upon these normative data, for every study participant, seven pairs of LVM z-scores were calculated based on her/his actual LVM. Each pair consisted of z-scores computed based on sex-specific and non-specific normative data from the same set. Results The regression lines fitted to the data points corresponding to LVM of boys had a higher slope than of girls, indicating that sex affects the relationship between LVM and body size. The mean differences between the paired LVM z-scores differed significantly from 0. The percentage of discordant indications, depending on the normalization method, ranged from 66.7% to 100% in girls and from 35.4% to 50% in boys. Application of the LVM normative

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Section: Plos Onesupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Left ventricular mass normalization in child and adolescent athletes must account for sex differences

et al. 2020

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“…In a recent study, we showed that among the frequently used body size variables, i.e., body surface area (BSA), lean body mass calculated based on predictive equations, and height, only height provides reliable normalization of LVM [11]. This study is a continuation of our previous work.…”

Section: Introductionmentioning

confidence: 55%

“…A question thus arises: what body size variable is the best for LVM normalization? In our recent study, we indicated that among commonly used scaling variables, like BSA, LBM computed based on the predictive equation, and height, only height allows for reliable evaluation of LVM in child and adolescents athletes [11]. This is because normalized LVM is underestimated after normalization against BSA or computed LBM in subjects with high body mass, like speed and strength athletes, and overweight and obese subjects.…”

Section: Discussionmentioning

confidence: 99%

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Left ventricular mass normalization for body size in children based on an allometrically adjusted ratio is as accurate as normalization based on the centile curves method

Krysztofiak¹,

Młyńczak²,

Małek³

et al. 2019

PLoS ONE

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BackgroundNormalization for body size is required for reliable left ventricular mass (LVM) evaluation, especially in children due to the large variability of body size. In clinical practice, the allometrically adjusted ratio of LVM to height raised to the power of 2.7 is often used. However, studies presenting normative LVM data for children recommend centile curves as optimal for the development of normative data. This study aimed to assess whether the allometrically adjusted LVM-to-height ratio can reliably reproduce the results of LVM normalization for height based on the centile curves method.MethodsLeft ventricular mass was computed for 464 boys and 327 girls, 5–18 years old, based on echocardiographic examination. Normalized data representing LVM for height were developed using the centile curves construction method and two variants of the allometrically adjusted ratio method: one variant with the allometric exponents specific to the study groups, and one variant with the universal exponent of 2.7. The agreement between the allometric methods and the centile curves method was analyzed using the concordance correlation coefficient, sensitivity, and specificity.ResultsFor both the specific allometric variant and the universal variant, the analysis of concordance has indicated high reproducibility compared to the centile curves method. The respective coefficient values were 0.9917 and 0.9916 for girls, and 0.9886 and 0.9869 for boys. The sensitivity and specificity test has also shown high agreement. However, for girls, the sensitivity was higher for the specific variant (100% vs. 90.9%).ConclusionThe results of the study show that allometric scaling of LVM for height can very reliably reproduce the results of LVM normalization for height based on the centile curves method. However, the analysis of sensitivity and specificity indicates greater agreement for the allometric normalization with the group-specific allometric exponents.

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Height Versus Body Surface Area to Normalize Cardiovascular Measurements in Children Using the Pediatric Heart Network Echocardiographic Z-Score Database

Mahgerefteh¹,

Lai

Colan

et al. 2021

Pediatr Cardiol

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Left ventricular mass is underestimated in overweight children because of incorrect body size variable chosen for normalization

Cited by 8 publications

References 42 publications

Left ventricular mass normalization in child and adolescent athletes must account for sex differences

Left ventricular mass normalization in child and adolescent athletes must account for sex differences

Left ventricular mass normalization for body size in children based on an allometrically adjusted ratio is as accurate as normalization based on the centile curves method

Height Versus Body Surface Area to Normalize Cardiovascular Measurements in Children Using the Pediatric Heart Network Echocardiographic Z-Score Database

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