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Updated: May 16, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Left ventricular mass by echocardiographic measures in children and adolescents
1Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA. kemeht@ccf.org
Insights
Left ventricular mass/height is a better indicator of obesity in children than other measures. This index can help track cardiovascular risk from youth into adulthood.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Risk Assessment
- Pediatric Obesity
Background:
- Left ventricular mass (LVM) indices predict cardiovascular outcomes in adults.
- LVM/height is superior to LVM/body surface area (BSA) and LVM/height in adults.
- Pediatric LVM/height standards are lacking; body mass index (BMI) is used as a risk factor.
Purpose of the Study:
- To assess the association between LVM indices and obesity in children.
- To determine if LVM/height is a reliable indicator of obesity-associated left ventricular hypertrophy (LVH) in pediatric populations.
Main Methods:
- Retrospective study of 692 clinically normal children (age 1 day to 18 years).
- Echocardiographic assessment of LVM.
- Statistical analysis using correlations, t-tests, and linear regressions to compare LVM/height, LVM/BSA, and LVM/height with BMI.
Main Results:
- LVM/height showed a stronger correlation with BMI (R2 = 0.36) compared to LVM/BSA (R2 = 0.179) and LVM/height (R2 = 0.006).
- Obese children had a higher prevalence of elevated LVM/height compared to other indices.
- All three LVM indices demonstrated a significant correlation with BMI (p < 0.035).
Conclusions:
- LVM/height is a reliable and convenient indicator of obesity-associated LVH in children.
- LVM/height facilitates consistent long-term cardiovascular risk monitoring from youth to adulthood.
- LVM/height should be incorporated into future pediatric cardiovascular risk and prevention studies.
Background:
Recent evidence in adults suggests that left ventricular mass measured as left ventricular mass/height predicts cardiovascular morbidity and mortality better than the two widely used indices, left ventricular mass/body surface area and left ventricular mass/height Standards of left ventricular mass/height have not been reported in children, for whom, owing to lack of significant cardiovascular morbidity and mortality, body mass index has traditionally been used as a potential cardiovascular risk factor.
Methods:
In this retrospective study, 692 clinically normal children aged 1 day to 18 years underwent detailed echocardiographic assessment to assess whether any of the left ventricular mass indices--left ventricular mass/height, left ventricular mass/body surface area, and left ventricular mass/height--are associated with obesity as measured by body mass index. Correlations, t-tests, and linear regressions were used for statistical testing.
Results:
Left ventricular mass/height was better correlated (R2 = 0.36) with body mass index than left ventricular mass/body surface area (R2 = 0.179) and left ventricular mass/height (R2 = 0.006), although all three dependent variables show a significant correlation (p < 0.035). In addition, a higher percentage of obese patients were noted to have elevated left ventricular mass as measured by left ventricular mass/height than by the other two methods.
Conclusions:
Left ventricular mass/height is a reliable indicator of obesity associated left ventricular hypertrophy. Left ventricular mass/height can be used conveniently during transitions from youth to adults for long-term follow-up. These findings support the importance of including left ventricular mass/height in future studies of cardiovascular risks and preventive strategies in children and adolescents.
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