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Body size adjustments for left ventricular mass by cardiovascular magnetic resonance and their impact on left ventricular hypertrophy classification

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Abstract

Methods to index left ventricular (LV) mass, measured by cardiovascular magnetic resonance (CMR), for body size have not been investigated. The purposes of this study were to develop allometric indices for LV mass measured by CMR and compare estimates of the prevalence and predictive value of LV hypertrophy defined by a new allometric height-weight index, LV mass/body surface area (BSA), height indices (a new allometric height index; and previously derived indices from echocardiographic measurements: LV mass/height2, LV mass/height2.7), and non-indexed LV mass. 5,004 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with CMR measurements of LV mass and no clinical cardiovascular disease at baseline were followed for a median of 4.1 years. The new indices and limits for hypertrophy (95th percentile) were derived from 822 normal-weight, normotensive, non-diabetic MESA participants. 107 events (coronary heart disease or stroke) were observed. The estimated prevalence of hypertrophy at baseline and hazard ratio for event associated with hypertrophy were 8% and 2.4 with the new allometric height-weight index, 11% and 2.2 with LV mass/BSA, 23–24% and 2.0–2.1 with height indices, and 20% and 1.7 with non-indexed LV mass. A statistically significant difference was detected between the hazard ratios based on the new height-weight index and non-indexed LV mass. The prevalence of hypertrophy is higher for indices that do not account for weight. The predictive value of hypertrophy is significantly better with the new allometric height-weight index than with non-indexed LV mass and may be better than indices without weight.

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Acknowledgments

The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.

Funding sources

This research was supported by contracts N01-HC-95159 and N01-HC-95168 from the National Heart, Lung, and Blood Institute.

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Authors and Affiliations

  1. Department of Biostatistics, University of Washington, Box 357232, Seattle, WA, 98195-7232, USA

    Lyndia C. Brumback & Richard Kronmal

  2. Department of Epidemiology, University of Washington, Seattle, WA, 98195, USA

    Susan R. Heckbert

  3. National Heart, Lung, and Blood Institute, Bethesda, MD, USA

    Hanyu Ni

  4. Departments of Medicine and Radiology, Wake Forest University, Winston-Salem, NC, USA

    W. Gregory Hundley

  5. Department of Medicine and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA

    João A. Lima

  6. Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA

    David A. Bluemke

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  1. Lyndia C. Brumback
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  3. Susan R. Heckbert
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  4. Hanyu Ni
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Correspondence to Lyndia C. Brumback.

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Brumback, L.C., Kronmal, R., Heckbert, S.R. et al. Body size adjustments for left ventricular mass by cardiovascular magnetic resonance and their impact on left ventricular hypertrophy classification. Int J Cardiovasc Imaging 26, 459–468 (2010). https://doi.org/10.1007/s10554-010-9584-5

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