Stroke Volume and Cardiac Output in Normotensive Children and Adults

Author:

de Simone Giovanni1,Devereux Richard B.1,Daniels Stephen R.1,Mureddu GianFrancesco1,Roman Mary J.1,Kimball Thomas R.1,Greco Rosanna1,Witt Sandra1,Contaldo Franco1

Affiliation:

1. From the Division of Cardiology, New York (NY) Hospital–Cornell Medical Center (G.deS., R.B.D., M.J.R.); the Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy (G.deS., G.M., R.G., F.C.); and Children’s Hospital Medical Center, Division of Cardiology, Department of Pediatrics, University of Cincinnati (Ohio) (S.R.D., T.R.K., S.W.).

Abstract

BackgroundRelations between organs and body size are not linear but rather follow allometric (growth) relations characterized by their powers (exponents).Methods and ResultsStroke volume (SV) by M-mode echocardiography was related to height, weight, body surface area (BSA), and ideal BSA (derived from ideal body weight for given height) in 970 normotensive individuals (1 day to 85 years old; 426 <18 years old; 204 overweight to obese; 426 female). In normal-weight children, adults, and the entire population, SV was related by allometric relations to BSA (power=0.82 to 1.19), body weight (power=0.57 to 0.71), and height (power=1.45 to 2.04) (allP<.0001). Relations of cardiac output to measures of body size had lower allometric powers than those for SV in the entire population (0.41 for body weight, 0.62 for BSA, and 1.16 for height). In overweight adults, observed SVs were 17% greater than predicted for ideal BSA, a difference that was approximated by normalization of SV for height to age-specific allometric powers. Similarly, observed cardiac output was 19% greater than predicted for ideal BSA, a difference that was accurately detected by use of cardiac output/height to age-specific allometric powers but not of BSA to the first power.ConclusionsIndexations of SV and cardiac output for BSA are pertinent when the effect of obesity needs to be removed, because these indexations obscure the impact of obesity. To detect the effect of obesity on LV pump function, normalization of SV and cardiac output for ideal BSA or for height to its age-specific allometric power should be practiced.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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