CLINICAL STUDIES
The associations of body size and body composition with left ventricular mass: impacts for indexation in adults
Hans-Werner Hense, MDa,
Birgit Gneiting, MSc*,
Michael Muscholl, MD ,
Ulrich Broeckel, MD,
Bernhard Kuch, MDa,
Angela Doering, MD*,
G.ünter A. J. Riegger, MD and
Heribert Schunkert, MD
a Institute of Epidemiology and Social Medicine, Clinical Epidemiology Unit, University Münster, Münster, Germany
* Institute for Epidemiology, GSF National Research Center, Munich-Neuherberg, Germany
Department of Internal Medicine II, University Regensburg, Regensburg, Germany
Manuscript received September 26, 1997;
revised manuscript received April 1, 1998,
accepted April 17, 1998.
Address for correspondence: Prof. Dr. Hans-Werner Hense, University Münster, Institute of Epidemiology and Social Medicine - Clinical Epidemiology Unit-, D-48129 Münster, Germany
hense{at}uni-muenster.de
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 < 0.001). These gender differences disappeared (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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Abbreviations and Acronyms
| | BIA | = bioelectrical impedance analysis | | BMI | = body mass index | | LBM | = lean body mass | | LVH | = left ventricular hypertrophy | | LVM | = left ventricular mass |
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