Detection of Subclinical Cardiac Damage by Echocardiography in a Hypertensive Population with a High Prevalence of Obesity: Discrepancies According to the Indexing Method Used

pp. 6-13

Abstract

Background: Allometric height-based indexing improves the detection of cardiac target organ damage in overweight/obese hypertensives versus body surface area-based indexing; however, its use is not common in daily practice.

Objective: To compare the prevalence of left ventricular hypertrophy and/or left atrial enlargement according to the echocardiographic indexing method used, and to estimate the level of agreement and the percentage of reclassified subjects.

Methods: Descriptive, observational and prospective study. We included 150 adults with hypertension. Left ventricular mass was
indexed to body surface area and height^2,7. Maximum left atrial volume was indexed to body surface area and height². Subgroup analysis was performed according to body mass index categories. The degree of agreement between methods was evaluated with the Kappa index (k).

Results: Mean age was 57.1 years, 62.7% were women, 58.7% were obese. The prevalence of ventricular hypertrophy and left atrial
enlargement was higher with height-based indexing. The level of agreement for the detection of left ventricular hypertrophy with
both indices was considerable (k=0.76) but poor for the detection of left atrial enlargement (k=0.23). The discrepancy between the
methods was greater at higher body mass index. One third of the subjects were reclassified regarding the presence of cardiac target
organ damage by using height-based indexing.

Conclusion: Cardiac structures indexed to body surface area underestimate the presence of target organ damage in overweight/obese
hypertensive subjects. We suggest considering the systematic use of height-based indexing in hypertensive subjects.

How to cite this article: 

Travetto CM, Argento LV. Detection of Subclinical Cardiac Damage by Echocardiography in a Hypertensive Population with a High Prevalence of Obesity: Discrepancies According to the Indexing Method Used. Rev Argent Cardiol 2025;93:6-13. https://doi.org/10.7775/rac.v93.i1.20850