Key result
General pediatric LVM reference values falsely diagnose LVH in up to ~17% of child athletes.
Why the study?
Regular sport activity in children leads to physiological increases in LV myocardial thickness and mass, but specific normal values for LVM in child and adolescent athletes were lacking.
Does the use of athlete-specific normative data for left ventricular mass reduce false positive diagnoses of left ventricular hypertrophy in child and adolescent athletes compared to general population reference values?
Observational (n=791)
No
Does the use of athlete-specific normative data for left ventricular mass reduce false positive diagnoses of left ventricular hypertrophy in child and adolescent athletes compared to general population reference values?
Establishing specific normative data for left ventricular mass in child and adolescent athletes reduces false positive diagnoses of left ventricular hypertrophy compared to using general pediatric reference values.
General population references risk false-positive LVH in pediatric athletes; hypothesis-generating for athlete-specific norms pending prospective validation.
It has been demonstrated that regular sport activity in children leads to physiological changes in the heart including increased left ventricular (LV) myocardial thickness and mass (LVM). The aim of the study was to establish the first specific normal values of LVM for child and adolescent athletes. Parasternal long-axis, 2D-guided echocardiographic measurements were obtained from a group of 791 Caucasian child athletes (age 5-18 years, 58.7% boys). For the preparation of normative data, LVM-for-lean body mass (LBM) reference curves were constructed using the LMS method. Then, a simple correlation plot was constructed to analyse the concordant and discordant indications of left ventricular hypertrophy (LVH), defined as LVM-for-LBM above the 95th percentile, according to the newly created and previously published normative data on LVM-for-LBM in the general population of children. Reference scatter plots of LVM-for-LBM for boys and girls in the analysed group of children practicing sports were presented, showing mean values of LVM and z-scores. The application to the studied group of reference centiles established for the general population of children would lead to false positive misclassification of increased LVH in 5.8% of the girls and 17.0% of the boys. We present the first specific normative data for LV mass in relation to lean body mass in Caucasian children and adolescents engaged in regular sport activities. The application of specific normative data for LV mass results in fewer false positive findings of left ventricular hypertrophy in this group than that of reference values for general paediatric population.
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Krysztofiak et al. (2018) conducted an observational in Healthy child and adolescent athletes (n=791). Regular athletic training vs. General pediatric population was evaluated on False positive misclassification of left ventricular hypertrophy (LVH). Applying general pediatric reference values for left ventricular mass to child athletes leads to false positive left ventricular hypertrophy diagnoses in 5.8% of girls and 17.0% of boys.
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