Evaluation of the size of cardiac structures in patients with high body mass index

Abstract

Aims Isometric indexation of cardiac structures fails in patients with overweight. The aim of the study was to evaluate the LA indexed volume (LAVOL), left ventricular end‐diastolic diameter (LVEDD), left ventricular mass index (LVMI), and the aortic sinus diameter (AOSD) in healthy subjects with normal and high BMI and find the allometric correction exponent. Methods Four hundred and thirty patients without cardiac pathology were analyzed. Patients were divided into groups: Group I BMI < 24.9 187 patients, Group II BMI 25‐29.9 154 patients, Group III BMI 30‐34.9 63 patients, and Group IV 35‐39.9 26 patients. A Doppler echocardiogram was performed. The parameters indexed were compared between groups. When allometric growth was verified, the allometric coefficient was calculated. Results Male sex 242 p (56%), mean age: 44.87 ± 13.10 years, better correlation: LAVOL, LV mass, and AOSD with body surface area (BSA) (LAVOL R: .74, R2 .55, LV mass R: .73, R2: 0.53, AOSD R: .57, R2: .35), LVEDD with high (R: .63, R2: .39) were observed. A significant increase was observed in LAVOL and LVMI in the groups with increased BMI. We observed a decrease in the indexed AOSD and a marginal difference between groups in LVEDD. The allometric correction exponent calculated was as follows: LAVOL: 0.96 and for LVMI: 0.97. Conclusions Allometric correction is superior to isometric indexation to assess LAVOL and LVMI in obese and overweight patients. Allometric correction would allow differentiating deviations from VOLAI and IMVI attributable to obesity from those attributable to an associated pathology.

Variations in indexation of left atrial volume across different races

“…Importantly, studies report various ideal height exponents for LAV indexation. Previous reports demonstrate that exponents closer to 1.7–2 are ideal for LAV indexation [ 10 , 11 , 24 ], though other studies report ideal LAV indexation with height exponents closer to 1 [ [25] , [26] , [27] ], and this may represent the inherent variability in ethnicity, as demonstrated in our study. Moreover, previous studies reporting higher exponents likely had a greater proportion of Caucasian/White populations.…”

Improved identification of left atrial enlargement in patients with obesity

“…First, Zong et al found that allometric scaling was superior to conventional isometric indexation in a population of 717 patients with obesity with a mean BMI of 42.2 kg/m2 [ 30 ]. Second, in a paper by Carnavelini et al, a similar conclusion was drawn in 63 patients with mild, and 26 patients with moderate obesity [ 31 ]. Although both studies demonstrated that allometric scaling was superior to isometric scaling, potential supportive data regarding the relation of alternative indexing methods with LA function was not available.…”

Indexing of Left Atrial Volume by various body size parameters in the Indian non-obese normal subjects: Is there an incremental value ?

“… 15 , 16 There are few studies which have shown ideal LAV indexation with height exponents closer to 1. 17 , 18 This differences may be due to ethnic differences seen in the different population studied.…”