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September 12, 2026Journal of the American College of Cardiology156 citationsOpen Access

The associations of body size and body composition with left ventricular mass: impacts for indexation in adults

HHHans‐Werner HenseBGBirgit GneitingMMM Muscholl

Key Result

Indexation of left ventricular mass to lean body mass removed gender differences (p > 0.05) and reduced the impact of adiposity compared to traditional indexations.

Key Points

  • To investigate the relationships between body size, body composition, and left ventricular mass, and to evaluate how different indexing methods influence associations with sex, adiposity, and blood pressure.
  • Community-based survey of 1,371 adults (653 men and 718 women) aged 25 to 74 years.
  • Lean body mass was measured using bioelectric impedance analyses, and left ventricular mass was determined via two-dimensional guided M-mode echocardiography.
  • Left ventricular mass was indexed to body height, height^2.7, body surface area, and lean body mass to compare resulting associations.
  • Traditional indexation to height, height^2.7, or body surface area resulted in significantly higher left ventricular mass in men than women (p < 0.001), but this difference disappeared when indexed to lean body mass (p > 0.05).
  • Indexing to lean body mass reduced the estimated association between adiposity and left ventricular mass by more than 50% compared with traditional indexations.
  • Associations between blood pressure and left ventricular mass remained consistent and independent of the indexation method used.

Study Design

Type

Cross-Sectional (n=1,371)

PICO

P
Population
1,371 adults aged 25 to 74 years from a community survey assessed for body composition and left ventricular mass.
E
Exposure / Comparator
Indexation of left ventricular mass to lean body mass vs Traditional indexations (body height, body height^2.7, or body surface area)
O
Primary Outcome
Gender differences in left ventricular mass, p=> 0.05

Main Result

p-value: p=> 0.05

Abstract

OBJECTIVES: We investigated the relationship between body size, body composition and left ventricular mass (LVM) in adults, and assessed the impact of different indexations of LVM on its associations with gender, adiposity and blood pressure. BACKGROUND: The best way to normalize LVM for body size to appropriately distinguish physiologic adaptation from morbid heart morphology was discussed. METHODS: We undertook a community survey of 653 men and 718 women, aged 25 to 74 years. Lean body mass (LBM) was determined by bioelectric impedance analyses and LVM was assessed by two-dimensional guided M-mode echocardiography. RESULTS: After traditional indexations to body height, body height2.7, or body surface area, men had higher LVM than women (p 0.05) when LVM was indexed to LBM. The type of indexation also modified the strength of the association between adiposity and LVM. The estimated impact of body fat on LVM indexed to LBM was less than half that obtained with traditional indexations. In contrast, the magnitude of the associations of blood pressure with LVM was entirely independent of the type of indexation. CONCLUSIONS: This study showed the prominent influence of body composition on adult heart size. Indexation for LBM removed gender differences for LVM and reduced the impact of adiposity, but left the effects of blood pressure unchanged. We suggest that this approach be used for clinical and research applications.

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Cite This Study

Hense et al. (1998) conducted a cross-sectional in Healthy adults (n=1,371). Indexation of left ventricular mass to lean body mass vs. Traditional indexations (body height, body height^2.7, or body surface area) was evaluated on Gender differences in left ventricular mass (p=> 0.05). Indexation of left ventricular mass to lean body mass removed gender differences (p > 0.05) and reduced the impact of adiposity compared to traditional indexations.

synapsesocial.com/papers/6aa56d5420e5356c66b27d6fhttps://doi.org/10.1016/s0735-1097(98)00240-x
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