Tracking of Left Ventricular Mass in Children: Race and Sex Comparisons

BACKGROUND: Increased left ventricular (LV) mass is a predictor of cardiovascular disease in adults. The mechanism(s) for these observations are not fully understood. METHODS AND RESULTS: We repeatedly studied a biracial sample of children from ages 11 through 17 years. At visits 1 through 5, height, weight, and pubertal stage were determined. Blood pressure and heart rate were measured. M-mode and two-dimensional echocardiograms were performed with a 3.5-MHz transducer with the subject in the supine position. LV mass was calculated. Repeated-measures analysis using a mixed modeling approach was performed for LV mass. At all ages, boys had greater LV mass than girls. For the population as a whole, we found significant tracking correlations for LV mass between each interval of measurement and throughout the entire period of examination. The tracking correlation for the entire sample from visit 1 through visit 5 was r=.41. The LV mass in white children tracked from the youngest to the oldest. Black children tracked similarly from ages 1 to 15 years, but tracking was not significant across the widest interval, visit 1 through visit 5. Racial differences were found in the interactions of systolic blood pressure and heart rate, which magnified the differences in LV mass. During adolescence, LV mass tracks significantly in both black and white children. CONCLUSIONS: Interactive effects such as weight, blood pressure, and heart rate magnify sex and race differences in LV mass.