(Circulation. 1998;98:2538-2544.)
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports |
Relations of Left Ventricular Mass to Fat-Free and Adipose Body Mass
The Strong Heart Study
From the Department of Medicine, The New York Hospital-Cornell Medical Center, New York; the Aberdeen Area of the Indian Health Service, Rapid City, SD (T.K.W.); the University of Oklahoma School of Public Health Services, Oklahoma City (E.T.L.); the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md (R.R.F.); and the Medlantic Research Institute, Washington, DC (B.V.H.).
Correspondence to Richard B. Devereux, MD, Division of Cardiology, Box 222, The New York Hospital-Cornell Medical Center, New York, NY 10021. E-mail rbdevere{at}mail.med.cornell.edu
Background—It is unclear whether increased left ventricular (LV) mass in overweight individuals is related to their adiposity or to greater fat-free mass (FFM).
Methods and Results—We compared echocardiographic LV mass to FFM and adipose body mass by bioelectric impedance and to anthropometric measurements in 3107 American Indian participants in the Strong Heart Study. In men and women, the relations of LV mass and FFM (r=0.37 and 0.38, P<0.001) were closer (P<0.05 to <0.001) than they were with adipose mass, waist/hip ratio, body mass index, systolic blood pressure, height, or height2.7. Regression analyses showed that in men LV mass had the strongest independent relation with FFM, followed by systolic blood pressure and age (all P<0.001); in women, LV mass was related to FFM more strongly than it was to systolic blood pressure, age (all P<0.001), and diabetes (P=0.012). Adipose mass had no independent relation to LV mass. When waist/hip ratio or body mass index were substituted for adipose mass, LV mass was independently related to FFM (P<0.001) and body mass index (P=0.02) but not to waist/hip ratio in men and was independently related to FFM and waist/hip ratio (both P<0.001) but not to body mass index in women. Using 97.5 percentile gender-specific partitions for LV mass/FFM in reference individuals, we found that LV hypertrophy occurred in 20.8% of Strong Heart Study participants with hypertension, overweight , or diabetes compared with 10.5% and 16.7% by LV mass indexed for body surface area or height2.7.
Conclusions—LV mass is more strongly related to FFM than to adipose mass, waist/hip ratio, body mass index, or height-based surrogates for lean body weight; LV mass/FFM criteria may increase sensitivity to detect LV hypertrophy.
Key Words: obesity • echocardiography • hypertension • hypertrophy
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