Circulation, Vol 85, 1661-1665, Copyright © 1992 by American Heart Association
MM Goble, M Mosteller, WB Moskowitz and RM Schieken
BACKGROUND. Left ventricular (LV) hypertrophy is a predictor of
cardiovascular events in adults and has been observed in children and
adolescents with hypertension. We wanted to establish the determinants of
LV mass in normotensive preadolescent children. Our objectives were 1) to
produce a simplified and generalizable model of the clinical variables that
determine normal cardiac growth during childhood and 2) to understand
better why males have an increased LV mass relative to females, even as
children. METHODS AND RESULTS. In a group of 243 eleven-year-old children,
we analyzed anthropometric, hemodynamic, and echocardiographic data to
define which variables were predictors of echocardiographically determined
LV mass. Stepwise regression was used to predict LV mass overall, by sex,
and by body size (body mass index). Overall, LV mass was directly related
to weight, male sex, and systolic and diastolic blood pressure and
inversely related to resting heart rate and skin-fold thicknesses. Systolic
blood pressure was a determinant in boys but not in girls. Heart rate was a
weak inverse correlate in both sexes. When the data were analyzed by body
mass index quartile, weight was the sole predictor of LV mass in the
largest children. CONCLUSIONS. We conclude that in normotensive
preadolescent children, 1) weight, but not pondersity, is a strong
predictor of LV mass; 2) body fat is negatively associated with LV mass; 3)
boys have an increased LV mass relative to girls; and 4) boys and girls
have similar anthropometric determinants and may have different hemodynamic
determinants. Our data suggest that body size, and in particular lean body
mass, explains much of the variability in cardiac growth seen in children.
The influence of hemodynamic variables seems to be more limited. Our
findings are of general interest because, although hypertensive heart
disease is well described, the early developmental stages are not well
understood.
ARTICLES
Sex differences in the determinants of left ventricular mass in childhood. The Medical College of Virginia Twin Study
Department of Pediatrics, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0272.
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