Why the study?
Numerous pediatric echocardiographic normative data for left ventricular mass are not sex-specific, prompting investigation into whether normative data should be developed separately for girls and boys practicing sports.
Does sex-specific normalization of left ventricular mass alter the assessment of left ventricular hypertrophy in child and adolescent athletes compared to non-sex-specific normalization?
Does sex-specific normalization of left ventricular mass alter the assessment of left ventricular hypertrophy in child and adolescent athletes compared to non-sex-specific normalization?
Echocardiographic assessment of left ventricular mass in pediatric athletes requires sex-specific normative data to avoid underestimating hypertrophy in girls and overestimating it in boys.
Non-sex-specific LVM norms risk misclassifying LVH in pediatric athletes; hypothesis-generating for sex-specific references.
BACKGROUND: To assess left ventricular hypertrophy, actual left ventricular mass (LVM) normalized for body size has to be compared to the LVM normative data. However, only some published normative echocardiographic data have been produced separately for girls and boys; numerous normative data for the pediatric population are not sex-specific. Thus, this study aimed to assess whether the LVM normative data should be developed separately for girls and boys practicing sports. METHODS: Left ventricular mass was computed for 331 girls and 490 boys, 5-19 years old, based on echocardiography. The effect of sex on the relationship between LVM and body size was evaluated using a linear regression model. Seven sets of the LVM normative data were developed, using different methodologies, to test concordance between sex-specific and non-specific normative data. Every set consisted of normative data that was sex-specific and non-specific. Upon these normative data, for every study participant, seven pairs of LVM z-scores were calculated based on her/his actual LVM. Each pair consisted of z-scores computed based on sex-specific and non-specific normative data from the same set. RESULTS: The regression lines fitted to the data points corresponding to LVM of boys had a higher slope than of girls, indicating that sex affects the relationship between LVM and body size. The mean differences between the paired LVM z-scores differed significantly from 0. The percentage of discordant indications, depending on the normalization method, ranged from 66.7% to 100% in girls and from 35.4% to 50% in boys. Application of the LVM normative data that were not sex-specific made relative LVM underestimated in girls and overestimated in boys. CONCLUSION: The LVM normative data should be developed separately for girls and boys practicing sports. Application of normative data that are not sex-specific results in an underestimation of relative LVM in girls and overestimation in boys.
No takes yet. Share an insight, caveat, or question.
Krysztofiak et al. (2020) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: