Normal values of left-ventricular mass: echocardiographic findings from the PAMELA study

Background and Aim. Upper reference values of echocardiographic left ventricular (LV) mass in the European population are based on scanty data, mostly derived from northern European population-based samples. Furthermore, data in apparently healthy populations have included individuals with conditions affecting LV mass such as obesity, diabetes and masked hypertension. Thus, from 1,051 subjects with normal office blood pressure (BP) belonging to the PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) study population, we selected a group of 675 sustained normotensives in order to provide reliable echocardiographic reference values for defining the criteria of LVH. Methods. The study group (women 58%, mean age 42±11 yrs) was identified after excluding subjects with isolated home or ambulatory hypertension, obesity, diabetes, cardiovascular diseases and echocardiographic examinations of insufficient quality to evaluate LV mass. Results. Sex-specific upper limits of normality (mean plus 1.96 standard deviation) for LV mass, LV mass indexed to body surface area, height2.7and height were the following: 213 g, 114 g/m2, 51 g/h2.7, 123 g/h in men and 161 g, 99 g/m2, 47 g/h2.7, 101g/h in women. In multivariate analyses, body size measures and ambulatory BP levels were the most important correlates of LV mass. Conclusions. Our investigation by providing upper reference limits of LV mass in a southern European population sample, carefully selected after exclusion of a large number of conditions affecting LV mass, may offer a contribution for revising diagnostic criteria of echocardiographic LVH currently recommended by European hypertension guidelines.