Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
National Centre for Sports Medicine, Warsaw, Poland.
PLoS One. 2019 Nov 21;14(11):e0225287. doi: 10.1371/journal.pone.0225287. eCollection 2019.
Normalization for body size is required for reliable left ventricular mass (LVM) evaluation, especially in children due to the large variability of body size. In clinical practice, the allometrically adjusted ratio of LVM to height raised to the power of 2.7 is often used. However, studies presenting normative LVM data for children recommend centile curves as optimal for the development of normative data. This study aimed to assess whether the allometrically adjusted LVM-to-height ratio can reliably reproduce the results of LVM normalization for height based on the centile curves method.
Left ventricular mass was computed for 464 boys and 327 girls, 5-18 years old, based on echocardiographic examination. Normalized data representing LVM for height were developed using the centile curves construction method and two variants of the allometrically adjusted ratio method: one variant with the allometric exponents specific to the study groups, and one variant with the universal exponent of 2.7. The agreement between the allometric methods and the centile curves method was analyzed using the concordance correlation coefficient, sensitivity, and specificity.
For both the specific allometric variant and the universal variant, the analysis of concordance has indicated high reproducibility compared to the centile curves method. The respective coefficient values were 0.9917 and 0.9916 for girls, and 0.9886 and 0.9869 for boys. The sensitivity and specificity test has also shown high agreement. However, for girls, the sensitivity was higher for the specific variant (100% vs. 90.9%).
The results of the study show that allometric scaling of LVM for height can very reliably reproduce the results of LVM normalization for height based on the centile curves method. However, the analysis of sensitivity and specificity indicates greater agreement for the allometric normalization with the group-specific allometric exponents.
为了可靠地评估左心室质量（LVM），尤其是在儿童中，需要对体型进行标准化，因为体型的变异性很大。在临床实践中，经常使用将 LVM 与身高的比例进行体表面积校正后再升高到 2.7 次方的方法。然而，提出儿童正常 LVM 数据的研究建议，为了开发正常数据，百分位曲线是最佳选择。本研究旨在评估基于百分位曲线方法的 LVM 身高标准化后，体表面积校正的 LVM 与身高的比例是否能可靠地再现结果。
根据超声心动图检查，计算了 464 名男孩和 327 名 5-18 岁女孩的左心室质量。使用百分位曲线构建方法和两种体表面积校正比例方法的变体来开发代表身高 LVM 的标准化数据：一种变体使用特定于研究组的体表面积校正指数，另一种变体使用通用指数 2.7。使用一致性相关系数、灵敏度和特异性分析体表面积校正方法与百分位曲线方法之间的一致性。
对于特定的体表面积校正变体和通用变体，与百分位曲线方法相比，分析一致性表明具有较高的重现性。对于女孩，相应的系数值分别为 0.9917 和 0.9916，对于男孩，相应的系数值分别为 0.9886 和 0.9869。灵敏度和特异性测试也显示出高度的一致性。然而，对于女孩，特定变体的灵敏度更高（100%对 90.9%）。
研究结果表明，LVM 身高的体表面积校正可以非常可靠地再现基于百分位曲线方法的 LVM 身高标准化的结果。然而，灵敏度和特异性的分析表明，对于特定组的体表面积校正指数，体表面积校正的归一化更符合。
