Scaling Echocardiographic Cardiac Dimensions to Body Size: A Bayesian Analysis in Healthy Men and Women
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BACKGROUND: Proper scaling of cardiac dimensions is of paramount importance in making correct decisions in clinical cardiology. The usual normalization of cardiac dimensions to overall body size assumes an isometric relationship. We sought to investigate these relationships to obtain the best allometric coefficient (AC) for scaling. METHODS: Ninety-seven healthy volunteers were included. The dimensions to be scaled were the left atrial volume, the end-diastolic and end-systolic left ventricular volumes, and the diameter of the tricuspid annulus. A Bayesian statistical analysis was applied with isometric coefficients as priors. RESULTS: The linear correlations between cardiac dimensions and body size were modest, ranging from 0.12 (-0.10–0.32) for the left atrial volume and height to 0.70 (0.58–0.80) for the end-diastolic volume and height. The ACs varied across the different cardiac dimensions and body size measurements. For the best linear relationships, the isometric coefficients were outside the 95% highest density interval of the posterior distribution for the left atrial volume-weight (AC: 0.7; 0.4–0.9) and end-diastolic volume-height (AC: 2.3; 1.7–2.9), whereas they were different from 1 for the left atrial volume-weight, end-diastolic volume, and diameter of the tricuspid annulus-body surface area (AC: 0.6; 0.3–0.8). Not scaling the cardiac dimensions to their corresponding ACs can lead to important errors in size estimations of cardiac structure. CONCLUSIONS: The ACs found in this study are somewhat different from the corresponding isometric coefficients and often different from 1. This finding should be considered when normalizing cardiac structures to body size when making clinical decisions.
Abstract
BACKGROUND: Proper scaling of cardiac dimensions is of paramount importance in making correct decisions in clinical cardiology. The usual normalization of cardiac dimensions to overall body size assumes an isometric relationship. We sought to investigate these relationships to obtain the best allometric coefficient (AC) for scaling. METHODS: Ninety-seven healthy volunteers were included. The dimensions to be scaled were the left atrial volume, the end-diastolic and end-systolic left ventricular volumes, and the diameter of the tricuspid annulus. A Bayesian statistical analysis was applied with isometric coefficients as priors. RESULTS: The linear correlations between cardiac dimensions and body size were modest, ranging from 0.12 (-0.10–0.32) for the left atrial volume and height to 0.70 (0.58–0.80) for the end-diastolic volume and height. The ACs varied across the different cardiac dimensions and body size measurements. For the best linear relationships, the isometric coefficients were outside the 95% highest density interval of the posterior distribution for the left atrial volume-weight (AC: 0.7; 0.4–0.9) and end-diastolic volume-height (AC: 2.3; 1.7–2.9), whereas they were different from 1 for the left atrial volume-weight, end-diastolic volume, and diameter of the tricuspid annulus-body surface area (AC: 0.6; 0.3–0.8). Not scaling the cardiac dimensions to their corresponding ACs can lead to important errors in size estimations of cardiac structure. CONCLUSIONS: The ACs found in this study are somewhat different from the corresponding isometric coefficients and often different from 1. This finding should be considered when normalizing cardiac structures to body size when making clinical decisions.
참고문헌 (14)
- Gayon J, "History of the concept of allometry", Am Zool, 40, pp.748~758 (2000)
- de Simone G, "Left ventricular mass and body size in normotensive children and adults : assessment of allometric relations and impact of overweight", J Am Coll Cardiol, 20, pp.1251~1260 (1992)
- McMahon T, "Size and shape in biology", Science, 179, pp.1201~1204 (1973)
- Ponikowski P, "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure : The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)Developed with the special contribution of the Heart Failure Association(HFA)of the ESC", Eur Heart J, 37, pp.2129~2200 (2016)
- Vahanian A, "Guidelines on the management of valvular heart disease(version 2012) : the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology(ESC)and the European Association for Cardio-Thoracic Surgery(EACTS)", Eur J Cardiothorac Surg, 42, pp.S1~S44 (2012)
- Nishimura RA, "2014 AHA", ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology, J Am Coll Cardiol, pp.2014, 63[DOI]
- Bolstad WM, "Introduction to Bayesian Statistics", pp.235~ (2016), John Wiley & Sons
- Wakefield JC, "Bayesian analysis of linear and non-linear population models by using the Gibbs sampler", J R Stat Soc Ser C Appl Stat, 43, pp.201~221 (1994)
- Dewey FE, "Does size matter? Clinical applications of scaling cardiac size and function for body size", Circulation, 117, pp.2279~2287 (2008)
- Pelliccia A, "Physiologic left ventricular cavity dilatation in elite athletes", Ann Intern Med, 130, pp.23~31 (1999)
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", J Am Soc Echocardiogr, 28, pp.1.e14~39.e14 (2015)
- Gutgesell HP, "Growth of the human heart relative to body surface area", Am J Cardiol, 65, pp.662~668 (1990)
- Chirinos JA, "Left ventricular mass: allometric scaling, normative values, effect of obesity, and prognostic performance", Hypertension, 56, pp.91~98 (2010)
- de Simone G, "Normalization for body size and population-attributable risk of left ventricular hypertrophy : the Strong Heart Study", Am J Hypertens, 18, pp.191~196 (2005)
