Abstract 17830: Relationship of Left Ventricular Mass to Lean Body Mass in the Obese Pediatric Population
Introduction: Left ventricular hypertrophy (LVH) and obesity are established independent risk factors of cardiovascular mortality. Identifying increased left ventricular mass (LVM) in pediatric obese patients (pts) is complicated by the effect of indexing to body size. Lean body mass (LBM) has been proposed as a better indexing variable for LVM than height or body surface area (BSA). Our aim was to determine which indexing variable is most highly correlated with LVM in obese pediatric pts compared to normal weight controls.
Methods: A retrospective chart review identified pts between 2-18 years old who were not hypertensive and had normal echocardiograms between 1995 and 2015 at Boston Children’s Hospital. Pts were separated into 2 groups, overweight/obese (BMI ≥85th percentile) and normal weight controls (BMI <85th percentile). LVM was calculated with the 5/6 area length rule from echocardiogram images. LBM was calculated based on clinical factors using equations validated in children with dual-energy x-ray absorptiometry.
Results: Of the 1345 pts who met inclusion criteria, 321 were overweight/obese and 1024 had normal weight (controls). The median age was 11.9 (2.0-17.9); 56% were male. The median LVM was 93.8 gms (22.0 - 238.5) in obese pts vs. 76.5 gms (21.2 - 229.2) in controls. The median LBM was 36.5 kg (7.9 - 86.8) in obese pts vs. 29.5 kg (3.1 - 71.0) in controls. Correlations between LVM and anthropometric measures are shown in the Table (p<0.001 for all correlations). LBM explained the most variability in LVM for both obese pts and controls. Obesity was an effect modifier for all variables except BSA. For LBM, the slope was less steep in obese pts, indicating LVM did not increase as much for increases in LBM compared to controls.
Conclusions: In this cohort, LBM had the strongest relationship to LVM in both overweight/obese pts and normal weight controls. Indexing LVM with LBM may improve the identification of LVH in all children, even in the presence of excess weight.
Author Disclosures: S.M. Dusenbery: None. J.S. Kerstein: None. S.D. de Ferranti: None. M.M. Mendelson: None. S.D. Colan: None. K. Gauvreau: None. P. Arya: None.
- © 2016 by American Heart Association, Inc.