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A novel method of expressing left ventricular mass relative to body size in children

Bethany J Foster1, Andrew S Mackie, Mark Mitsnefes

  • 1Department of Pediatrics, Montreal Children's Hospital, Hospital, McGill University, Montreal, Quebec H3H 1P3, Canada. beth.foster@muhc.mcgill.ca

Circulation
|May 21, 2008
PubMed

Insights

Left ventricular mass-for-height centile curves offer a stable method for diagnosing left ventricular hypertrophy (LVH) in children, outperforming the traditional left ventricular mass index (LVMI) across diverse reference populations.

Area of Science:

  • Pediatric Cardiology
  • Biomedical Engineering
  • Growth and Development

Background:

  • Left ventricular hypertrophy (LVH) in children is typically defined using the left ventricular mass index (LVMI) exceeding the 95th percentile.
  • The LVMI's reliance on height distribution in reference populations introduces variability, especially in younger children where LVMI increases with decreasing height.

Purpose of the Study:

  • To compare the efficacy of a novel LV mass-to-body size normalization method using centile curves against the conventional LVMI method.
  • To evaluate the stability and reliability of LVH classification across different reference population height distributions.

Main Methods:

  • Left ventricular mass was assessed via M-mode echocardiography in 440 healthy children and 239 at-risk children.
  • LVMI was calculated, and LV mass-for-height centile curves were constructed using the Cole lambda-mu-sigma method.
  • At-risk children were classified for LVH using both sample-specific LVMI percentiles and the novel centile curve method.

Main Results:

  • The LV mass-for-height centile method yielded consistent estimates of the proportion of at-risk children with LVH, irrespective of the reference group's height distribution.
  • In contrast, LVMI-based proportion estimates for LVH varied significantly depending on the specific reference population used.
  • The centile curve approach demonstrated greater stability in classifying LVH across diverse pediatric populations.

Conclusions:

  • Left ventricular mass-for-height centile curves provide a more robust and reliable method for normalizing LV mass to body size in pediatric populations.
  • This novel approach overcomes the limitations of the LVMI, offering a stable diagnostic tool for LVH in children.
Abstract

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