Comparison among diagnosis of inappropriate left ventricular mass and the criteria of left ventricular hypertrophy by different indexation methods

초록

Background: The inappropriate LV mass(iLVM) is known to be associated with adverse prognosis which is comparable to appropriate LVH. But the significance of the iLVM group was not proven in a clinical setting. We retrospectively analyzed the influence on the diagnosis of abnormal LV mass by adoption of iLVM. Material and methods: 360 consecutive data of the subjects including 141 hypertension, and/or 45 diabetes, and/or 45 hypercholesterolemia patients without cardiac diseases from the echocardiography database in Hanyang University Hospital were analyzed. LVH was categorized by the criteria according to the indexation by body surface area(BSA) or height2.7. The abnormal LV mass was defined by the presence of any iLVM or LVH. Observed/predicted LV mass(OPR) > 130 % was defined as inappropriate. Results: Diagnosis of LVH was significantly different by indexation methods(16.8% vs 29.6%, for indexation by BSA and ht2.7 respectively, p= 0.0001). The abnormal LV was different between LVH by BSA versus iLVM(16.8% vs 29.0%) but not between LVH by ht2.7 and iLVM even when stratified by age or gender. When stratified by body mass index of 25kg/m2, iLVM is more sensitive criteron in non-obese patients(22% vs 16%, p=0.05). On the other hand, LVH is more sensitive criterion in obese patients(45% vs 36%, p=0.04). Conclusion: Diagnosis of LVH and iLVM is affected not only by indexation methods but also the presence of obesity. In patients with normal BMI, iLVM is more sensitive criterion to detect abnormality of LV mass.