(Circulation. 2000;102:405.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Body Composition and Prevalence of Left Ventricular Hypertrophy
From the Institute of Epidemiology and Social Medicine, Clinical Epidemiology Unit, University of Münster (B.K., H.-W.H.); the Institute of Epidemiology, GSF- National Research Center, München-Neuherberg (B.G., A.D.); the Department of Internal Medicine II, University of Regensburg (M.M., U.B., H.S.); and the Department of Internal Medicine I, Central Hospital, Augsburg (B.K.), Germany.
Correspondence to Hans-Werner Hense, MD, Institut für Epidemiologie und Sozialmedizin, Bereich Klinische Epidemiologie, University of Münster, Domagkstreet 3, D 48129 Münster, Germany. E-mail hense{at}uni-muenster.de
Background—Fat-free mass (FFM) has been proposed as an optimal normalization of left ventricular (LV) mass to body size. We sought to evaluate the novel FFM-based criteria of LV hypertrophy (LVH).
Methods and Results—A population sample of 1371 men and women aged 25 to 74 years was examined by echocardiography and bioelectrical impedance analysis. Internal partition values for LVH were generated in a healthy population subgroup on the basis of LV mass divided by FFM and by the traditional indexations to body height, height2.7, and body surface area. In contrast to the sex-specific criteria required by traditional indexations, the value of LV mass/FFM that divided individuals with and without LVH was identical for men and women (4.1 g/kg). Estimates of LVH prevalence varied significantly by type of indexation used, internally or externally derived cut points, and by population subgroups. Differences were pronounced among hypertensives and the obese. Thus, the application of LV mass/FFM more than halved the risk of LVH in obese versus nonobese women (odds ratio, 2.5; 95% confidence interval, 1.6 to 4.0) compared with criteria based on LV mass/height2.7 (odds ratio, 5.5; 95% confidence interval, 3.6 to 8.3). Implications among hypertensives were less marked.
Conclusions—Indexation of LV mass to FFM eliminates sex-specific LVH criteria. The proportion of individuals defined as having LVH using the new criteria deviate markedly from traditional indexations. Prospective investigations will be needed to identify the prognostic implications of different indexations, especially in subgroups such as the obese.
Key Words: hypertrophy • fat-free mass • obesity • epidemiology
This article has been cited by other articles:
 |
|
 |
|
  W. Lieb, B. Mayer, J. Stritzke, A. Doering, H.-W. Hense, H. Loewel, J. Erdmann, and H. Schunkert Association of low-grade urinary albumin excretion with left ventricular hypertrophy in the general population: The MONICA/KORA Augsburg Echocardiographic Substudy Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2780 - 2787. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Valle, E. Bagolin, C. Canali, P. Giovinazzo, S. Barro, N. Aspromonte, E. Carbonieri, and L. Milani The BNP assay does not identify mild left ventricular diastolic dysfunction in asymptomatic diabetic patients Eur J Echocardiogr, January 1, 2006; 7(1): 40 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.v. Lukowicz, M. Fischer, H.W. Hense, A. Doring, J. Stritzke, G. Riegger, H. Schunkert, and A. Luchner BNP as a marker of diastolic dysfunction in the general population: Importance of left ventricular hypertrophy Eur J Heart Fail, June 1, 2005; 7(4): 525 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. de Simone, K. Wachtell, V. Palmieri, D. A. Hille, G. Beevers, B. Dahlof, U. de Faire, F. Fyhrquist, H. Ibsen, S. Julius, et al. Body Build and Risk of Cardiovascular Events in Hypertension and Left Ventricular Hypertrophy: The LIFE (Losartan Intervention For Endpoint reduction in hypertension) Study Circulation, April 19, 2005; 111(15): 1924 - 1931. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Dorr, B. Wolff, D. M. Robinson, U. John, J. Ludemann, W. Meng, S. B. Felix, and H. Volzke The Association of Thyroid Function with Cardiac Mass and Left Ventricular Hypertrophy J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 673 - 677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Peterson, P. Herrero, K. B. Schechtman, S. B. Racette, A. D. Waggoner, Z. Kisrieva-Ware, C. Dence, S. Klein, J. Marsala, T. Meyer, et al. Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women Circulation, May 11, 2004; 109(18): 2191 - 2196. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fischer, A. Baessler, H.W. Hense, C. Hengstenberg, M. Muscholl, S. Holmer, A. Doring, U. Broeckel, G. Riegger, and H. Schunkert Prevalence of left ventricular diastolic dysfunction in the community: Results from a Doppler echocardiographic-based survey of a population sample Eur. Heart J., February 2, 2003; 24(4): 320 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Muntner, J. He, E. J. Roccella, and P. K. Whelton The Impact of JNC-VI Guidelines on Treatment Recommendations in the US Population Hypertension, April 1, 2002; 39(4): 897 - 902. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Zoccali, F. A. Benedetto, F. Mallamaci, G. Tripepi, G. Giacone, A. Cataliotti, G. Seminara, B. Stancanelli, and L. S. Malatino Prognostic Impact of the Indexation of Left Ventricular Mass in Patients Undergoing Dialysis J. Am. Soc. Nephrol., December 1, 2001; 12(12): 2768 - 2774. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D J R Hildick-Smith and L M Shapiro Echocardiographic differentiation of pathological and physiological left ventricular hypertrophy Heart, June 1, 2001; 85(6): 615 - 619. [Full Text]
|
|