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Revised definition of predicted left ventricular mass using ambulatory blood pressure in healthy Korean adults
Bae Keun Kim1, Enshi Xu2, Bo Youl Choi3
1Division of Cardiology, Department of Internal Medicine, Sung Ae General Hospital, Seoul, South Korea.
Insights
Stroke work, height, and sex are key factors influencing left ventricular mass in healthy Korean adults. Ambulatory blood pressure monitoring is more effective than clinical measurements for assessing stroke work and predicting left ventricular mass.
Area of Science:
- Cardiology
- Physiology
Background:
- Left ventricular hypertrophy is influenced by hemodynamic and non-hemodynamic factors.
- Ambulatory blood pressure is correlated with left ventricular hypertrophy.
- This study investigates the determinants of left ventricular mass in healthy Korean adults.
Purpose of the Study:
- To establish the influences of hemodynamic and non-hemodynamic factors on left ventricular mass variation.
- To compare the efficacy of ambulatory blood pressure versus clinical blood pressure in predicting left ventricular mass.
Main Methods:
- Analysis of data from 172 healthy Korean adults (71 males, 101 females) with normal BMI and blood pressure.
- Calculation of left ventricular mass using a standard formula.
- Calculation of stroke volume and stroke work using Teichholz's formula and ambulatory systolic blood pressure.
Main Results:
- Stroke work was the most significant determinant of left ventricular mass (adjusted R² = 0.442, p < 0.001), independent of height and sex.
- A regression model including stroke work, height, and sex predicted left ventricular mass (adjusted R² = 0.532, p < 0.001).
- The predictive equation for left ventricular mass was: 43.11 + 0.61 × SW + 9.21 × height^2.7 - 13.99 × sex.
Conclusions:
- Stroke work, height, and sex are important determinants of left ventricular mass in healthy Korean adults.
- Ambulatory blood pressure is superior to clinical blood pressure for determining stroke work and predicting left ventricular mass.
Background:
Left ventricular hypertrophy is influenced by both hemodynamic and non-hemodynamic factors. Ambulatory blood pressure is correlated with left ventricular hypertrophy. We established the influences of hemodynamic and non-hemodynamic factors, including ambulatory blood pressure, on variation in left ventricular mass in healthy Korean adults.
Method:
We included 172 subjects (male = 71, female = 101), with normal body mass index and blood pressure, in an analysis of data from the Yangpyung and Yeoju cohort studies and a tertiary cardiovascular center. Left ventricular mass was calculated using the equation: [1.04 × (IVSd + LVDd + PWTd) 3-(LDVs3)] × 0.8 + 0.6. Stroke volume was calculated (mL/beat) using Teichholz's formula. Stroke work (SW in gram-meters/beat [g-m/beat]) was computed as ambulatory systolic BP × stroke volume × 0.0144.
Results:
Stroke work was the most important determinant associated with left ventricular mass (adjusted R2 = 0.442, p < 0.001), independent of height2.7 and sex. In a regression model including stroke work, height,2.7 and sex, the left ventricular mass was predicted by the equation: 43.11 + 0.61 × SW (g-m/beat) + 9.21 × height2.7-13.99 × sex (male = 1, female = 2) (constant = 43.11 ± 25.88, adjusted R2 = 0.532, p < 0.001).
Conclusion:
We examined ambulatory blood pressure, as in previous studies, and identified stroke work, height2.7, and sex as important determinants of left ventricular mass in Korean adults of normal weight and normal blood pressure. Ambulatory blood pressure is superior to clinical blood pressure for determining stroke work and predicted left ventricular mass.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Pre-Procedural Guidelines for Assessing Blood Pressure

