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 mass rose by a statistically significant 4% from 1986 to 2008. The prevalence of left ventricular 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 left ventricular mass, Dr. Crowley said.
The investigation 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
Dr. Crowley and his associates identified 350 children matched by age and gender who underwent echocardiography at their center during 2008 for similar reasons and met similar clinical criteria. Both cohorts were 60% boys, and 82% or 83% were white.
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 left ventricular mass rose by only 4% from the older to more contemporary cohort, this difference is important, commented 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 and professor and chairman of pediatrics at the University of Colorado in Denver.
Dr. Crowley had no financial disclosures for the study.
This 'is the first study to look at average left ventricular mass in the whole pediatric population.'
Source DR. CROWLEY