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(Circulation. 1998;97:1893-1894.)
© 1998 American Heart Association, Inc.

Editorials

Clinical and Epidemiological Significance of Left Ventricular Mass Assessed in Children and Adolescents

Samuel S. Gidding, MD

From Northwestern University Medical School, Chicago, Ill.

Correspondence to Samuel S. Gidding, MD, 2300 Children's Plaza/MC #21, Chicago, IL 60614. E-mail s-gidding@nwu.edu

Key Words: Editorials • pediatrics • ventricles • hypertension • risk factors • left ventricular mass

The ability to measure left ventricular mass (LVM) by echocardiography has led to an important understanding of the contribution of inappropriate LVM to the pathogenesis of cardiovascular disease. In particular, the identification by Levy et al,¹ in the Framingham Study, of increased LVM as a risk factor for cardiovascular morbidity and mortality independent of conventional risk factors, including obesity and hypertension, initiated many studies by independent investigators to better understand the clinical significance of this finding.

Because children and adolescents grow rapidly and their blood pressure increases with age, pediatric studies have been important in understanding the evolution of LVM in generally healthy individuals. Cross-sectional studies have shown that the major determinants of left ventricular growth are body size and sex, with a smaller contribution made by blood pressure.^{2 3} Allometric relationships between somatic and cardiac growth have been established, and although these coefficients vary slightly from study to study, they consistently explain a significant percentage of mass variation.^{2 3} The importance of somatic growth as the major determinant of left ventricular growth has been established by repeat measurements of mass over a 5-year interval in the Bogalusa Heart Study and by the recognition that lean body mass contributes somewhat more to cardiac growth than fat mass.^{4 5}

In this issue of Circulation, Schieken et al⁶ complete the epidemiological work necessary to understand the characteristics of LVM in children. LVM tracks from early to late adolescence in black and white boys and girls to about the same degree as other important risk . . . [Full Text of this Article]

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