ORLANDO — A growing number of American children have increased left ventricular mass, a marker for cardiovascular disease risk.
The finding was noted in a study that included 700 children and “is the first study to look at average left ventricular mass in the whole pediatric population,” according to Dr. David I. Crowley, a pediatric cardiologist at Cincinnati Children's Hospital.
In children with an average age of 10 years, mean left ventricular (LV) mass rose by a statistically significant 4% from 1986 to 2008. The prevalence of LV hypertrophy in the children more than doubled, from 7% to 15%, Dr. Crowley said at the annual scientific sessions of the American Heart Association.
The increase appears to be linked to obesity. In the 1986-1988 cohort of 350 children examined at Cincinnati Children's, the prevalence of overweight was 14% and of obesity was 5%. In a matched cohort of 350 children assessed in 2008, the prevalence of overweight was 15% but the prevalence of obesity soared to 19%. Results from a multivariate analysis showed that body mass index was a major determinant of LV mass, Dr. Crowley said.
The study included children aged 2-19 years. The participants came to Cincinnati Children's in 1986-1988 for an echocardiography examination because of a murmur, palpitations, syncope, or chest pain. All 350 children included in the analysis had normal cardiac anatomy and function, and none had systemic disease or a body mass index of 40 kg/m
Analysis of the echocardiographic data showed that, in addition to having larger hearts, the more recently evaluated children also had a greater prevalence of high-risk cardiac morphology. The prevalence of eccentric hypertrophy was 6% in the 1986-1988 group and 12% in the 2008 cohort. The prevalence of concentric hypertrophy also doubled in the more recent cohort.
Although average LV mass rose by only 4% from the older to more contemporary cohort, this difference is important, said Dr. Stephen R. Daniels. “When you look at a population and a value gets worse by even a small amount, it suggests that many more in the population may now be in a high-risk category,” said Dr. Daniels, a pediatric cardiologist at the University of Colorado in Denver.
Dr. Crowley had no financial conflicts.
In the 2008 cohort, 'the prevalence of obesity soared to 19%' vs. 5% in the 1986-1988 cohort.
Source DR. CROWLEY