Indexing left ventricular mass to fat-free mass rather than traditional body size metrics may improve the sensitivity of detecting left ventricular hypertrophy.
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.
Bella et al. (Tue,) studied this question.