From the Division of Cardiology, The New York Hospital–Cornell
Medical Center, New York, NY (G. de S., R.B.D., M.J.R.); the Department of
Clinical and Experimental Medicine, Federico II University Hospital, Naples,
Italy (G. de S., G.F.M., F.C.); and Children's Hospital Medical Center,
Division of Cardiology, Department of Pediatrics, University of Cincinnati
(Ohio) (T.R.K., S.R.D.).
Correspondence to Dr Giovanni de Simone, Department of Clinical and Experimental Medicine, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy. E-mail simogi{at}unina.it
Abstract—The development of
the left ventricle parallels body growth. During infancy, the relation
between body size and left ventricular (LV) mass is very
close. With advancing age, variability of LV mass in relation to body
size markedly increases. To test the hypothesis that the age-related
increase in variability of LV mass is due to the progressive impact of
hemodynamic stimuli on LV growth, quantitative M-mode
echocardiograms were obtained in 766 normal-weight, normotensive
individuals over a range of ages from 1 day to 85 years (330 female
subjects, 373 subjects younger than 18 years). LV mass was linearly
related to height2
(r2=.69). Prediction of values of LV
mass by body size was more accurate at birth and progressively less
precise with increasing age. Stroke work (stroke volume times
systolic pressure) was closely related to LV mass
(r2=.74). The explained variance of
LV mass increased from 69% in the univariate regression
with height2 to 82% in a multivariate
model including height2.7, stroke work, and gender. In
children and adolescents (younger than 18 years), height2
was the main determinant of LV mass, whereas during adulthood stroke
work and gender were more important predictors of LV mass than
height2.7. Thus (1) the influence of body growth on
development of LV mass decreases after early infancy because of both
the variability of hemodynamic load and the increasing
effect of gender; (2) after adolescence, during adulthood, in
normotensive, normal-weight individuals, the impact of
hemodynamic load and male gender on LV mass is greater
than the one of body size; and (3) an appreciable proportion of
variability of LV mass remains unexplained with the studied models.
This might be due to genotypic variations and/or measurement
error.
© 1998 American Heart Association, Inc.
Scientific Contributions
Interaction Between Body Size and Cardiac Workload
Influence on Left Ventricular Mass During Body Growth and Adulthood
Key Words: age • hemodynamics • gender • ventricular function, left • hypertrophy, left ventricular
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