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Anthropometric, demographic, and cardiovascular predictors of left ventricular mass in young children
D P Papavassiliou1, F A Treiber, W B Strong
1Department of Pediatrics, Medical College of Georgia, Augusta 30912-3710, USA.
Insights
Childhood weight and cardiac output reactivity predict future left ventricular (LV) mass. Early weight control may prevent later cardiovascular disease in children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Growth and Development
Background:
- Left ventricular (LV) mass is a critical predictor of cardiovascular morbidity and mortality.
- Longitudinal studies on pediatric LV mass predictors are limited.
- Understanding early determinants of LV mass is crucial for cardiovascular disease prevention.
Purpose of the Study:
- To identify anthropometric, demographic, and cardiovascular predictors of LV mass in children.
- To assess predictors of LV mass and geometry 3.6 years after initial examination.
- To explore factors influencing LV mass/height2.7 and relative wall thickness.
Main Methods:
- Longitudinal study of 68 children (aged 7.9 ± 0.7 years) with initial and follow-up examinations (3-4 years later).
- Measurements included anthropometrics, hemodynamics (rest and during stressors: postural change, cold stimulation, treadmill exercise), and echocardiography.
- Hierarchical stepwise multiple regression analyses were used to identify significant predictors.
Main Results:
- Initial weight, height, and cardiac output reactivity to standing/treadmill exercise predicted LV mass (R2=0.55).
- LV mass/height2.7 was predicted by initial adiposity and cardiac output/systolic pressure reactivity to postural change (R2=0.25).
- Relative wall thickness was predicted by ethnicity, adiposity, and systolic pressure reactivity to postural change (R2=0.28).
Conclusions:
- Childhood weight and dynamic cardiovascular responses are significant predictors of LV mass.
- Adiposity and blood pressure/cardiac output reactivity also influence LV geometry.
- Weight management in childhood may serve as a primary prevention strategy for adult cardiovascular disease.
Abstract:
Left ventricular (LV) mass is a strong independent predictor of cardiovascular morbidity and mortality. Few longitudinal studies have examined predictors of LV mass in children. This study assessed the contributions of anthropometric, demographic, and cardiovascular parameters (at rest and after exposure to laboratory stressors) as predictors of LV mass 3.6 years after the initial examination in a sample of 68 Caucasian and African-American children 7.9 +/- 0.7 years old. At the initial examination, all subjects had standard anthropometrics measured and hemodynamics assessed at rest and during 3 stressors: postural change, forehead cold stimulation, and treadmill exercise. On the follow-up examination 3 to 4 years later, echocardiographic evaluations were conducted to estimate LV mass and related LV geometry. LV mass and LV internal diameter in diastole were adjusted for linear growth (LV mass/height2.7 and LV internal dimension during diastole/height0.80, respectively). Hierarchical stepwise multiple regression analyses were conducted using parameters significant in univariate comparisons (p < 0.05). Initial weight (R2 = 0.38), height (R2 = 0.42), and cardiac output reactivity to standing and treadmill exercise (final model R2 = 0.55) were significant predictors of LV mass, whereas LV mass/height2.7 was predicted by initial adiposity (R2 = 0.07) and cardiac output and systolic pressure reactivity to postural change (final model R2 = 0.25). Follow-up relative wall thickness was significantly predicted by ethnicity (African-Americans greater than Caucasians, R2 = 0.15), adiposity (R2 = 0.20), and systolic pressure reactivity to postural change (final model R2 = 0.28). These findings suggest the potential benefit of weight control in childhood as a primary prevention for later onset of cardiovascular disease.