Why the study?
Does indexing left ventricular mass by height squared compared to body surface area improve the detection of left ventricular hypertrophy in obese hypertensive and normotensive patients?
Does indexing left ventricular mass by height squared compared to body surface area improve the detection of left ventricular hypertrophy in obese hypertensive and normotensive patients?
Indexing left ventricular mass by height squared rather than body surface area is more appropriate for detecting left ventricular hypertrophy in obese populations, as BSA underestimates LVH by treating obesity as a physiological variable.
May support height-squared over BSA indexing for LVH detection in obesity; leaves open prospective validation before practice change.
PURPOSE: To evaluate left ventricular mass (LVM) index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA) and for height2 (LVM/h2). The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI): <27; 27-30; >/= 30kg/m2. RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height2 provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH) has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height2 allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.
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Rosa et al. (2002) studied this question.
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