Abstract
Daniels et al,1 in this issue of Circulation, used the technique of dual-energy x-ray absorptiometry to determine lean body mass and asked two questions: What determines echocardiographic left ventricular (LV) mass in children, and is LV mass a modifiable risk factor for coronary heart disease? There are important reasons to consider that LV hypertrophy in children may be a coronary heart disease risk factor. LV hypertrophy, as detected by the ECG in hypertensive adults studied in the Framingham Heart Study, is recognized to be a serious risk factor for the development of coronary heart disease.2 In subsequent studies, investigators from that study discovered that the identification of LV hypertrophy by echocardiographic rather than by ECG measures is an even more powerful predictor of coronary heart disease than hypertension.3 4 Therefore, the appearance of echocardiographic LV hypertrophy in adults is an important finding that may presage a disease state. After the identification of risk factors for the development of coronary heart disease in adults, investigators described the distribution of these risk variables …
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