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Geographic variation in left ventricular mass and mass index: a systematic review

Journal of Human Hypertension volume 26, pages 420–429 (2012)Cite this article

Abstract

Left ventricular (LV) hypertrophy, defined as an abnormal increase in LV mass (LVM), is an important prognostic indicator and therapeutic target. LVM is often divided by body surface area to derive indexed mass; however, this does not correctly identify pathological LV hypertrophy in all people, especially when body composition is altered, or in different ethnic groups. We evaluated published ranges of echocardiographic LVM in healthy adult populations from different countries, excluding control groups, and compared them with the American Society of Echocardiography reference ranges. A total of 33 studies met the inclusion criteria. In men and women, there was wide variation in the ranges of LVM with a tendency for the upper limit to increase geographically westward; this variation remained for indexed mass. Several ranges fell outside the upper reference limits: in men, 13 of the mass ranges and 16 of indexed mass; and in women, 8 mass and 16 indexed mass. This review has shown that current guidelines may need revision as some published series suggest that greater LV mass should be considered normal. This may be explained by ethnic differences and supports the need for widely applicable and ethnically diverse reference ranges to be established.

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Acknowledgements

We gratefully acknowledge the investigators that provided further information on their studies, including recalculation of gender-specific data: Dr Esmeray Acarturk, Turkey; Dr David Antoniucci, Italy; Dr Eli Botvinick, USA; Dr Solomon Danbauchi, Nigeria; Dr Jerome Fleg, USA; Dr OP Gupta, India; Dr Stephen Harrap, Australia; Drs Carolyn Lam, Margaret Redfield, Richard Rodeheffer, USA; Dr Britta Lind, Sweden; Dr Jose Geraldo Mill, Brazil; Dr Jan Erik Otterstad, Norway. This work was supported by a Summer Student Scholarship from the University of Auckland (MEB) and a Post-Graduate Scholarship from the National Heart Foundation of New Zealand (KKP).

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Authors and Affiliations

  1. Department of Medicine, The University of Auckland, Auckland, New Zealand

    K K Poppe, M Edgerton Bachmann, R N Doughty & G A Whalley

  2. Department of Statistics, The University of Auckland, Auckland, New Zealand

    K K Poppe & C M Triggs

  3. Faculty of Social and Health Sciences, Unitec, Auckland, New Zealand

    G A Whalley

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Correspondence to K K Poppe.

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Poppe, K., Bachmann, M., Triggs, C. et al. Geographic variation in left ventricular mass and mass index: a systematic review. J Hum Hypertens 26, 420–429 (2012). https://doi.org/10.1038/jhh.2011.56

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