Indexation criteria of ventricular mass and predictive role of blood pressure and body composition

Background: There is no definite consensus on which indexation of left ventricular mass (LVM) should be used to better identify left ventricular hypertrophy (LVH) Left ventricular mass has been adjusted to height, to height(2.7) (h(2.7)) and to body surface area (BSA). The aims of the present study were to evaluate the prevalence of LVH according to different indexations and different cutoffs and to identify the most useful indexation of LVM to detect hypertension-related LVH. Methods: Echocardiographic LVH was defined as LVM to h(2.7), LVM to BSA, LVM to height, LVM values in the upper 5th percentile of our gender-related LVM distribution, using different partition values suggested in previous population-based studies. Results: Prevalence of LVH in the general population was 32% using the less restrictive criterion (LVH 49.2/46.7 g/m(2.7)), 15% with the criterion of LVH 116/104 g/m(2), and 3.8% with the most restrictive one (LVH 134/110 g/m(2)). Prevalence of LVH in hypertensive subjects was almost twice than in normotensive subjects with all criteria. Only 20 subjects out of the 707 evaluated were found to have LVH with all six criteria. In multiple regression analysis SBP was independently associated with nonindexed LVM and was indexed to both BSA and h(2.7). On the other hand, fat-free mass was a poweful predictor of nonindexed LVM or of LVM to BSA, whereas body mass index was the strongest predictor of LVM to h(2.7). Conclusions: The indexation of LVM to BSA, possibly with the cut-off of LVH 116/104, is probably the best criterion for identifying blood pressure-related LVH.