Author + information
- Theophilus Owan, MD and
- Sheldon E. Litwin, MD⁎ ()
- ↵⁎Georgia Health Sciences University, Medical College of Georgia, 1120 15th Street, Augusta, Georgia 30912
On behalf of our coauthors, we thank Drs. Spevack and Chandra for their letter regarding our work (1). We fully agree with their comments. The issue of how to optimally index cardiac chamber sizes to body size is significantly more complex than one might imagine. In an era when 70% of the U.S. population are obese or overweight and 5% to 7% are severely obese, the use of body surface area as an indicator of overall body size is fraught with potential error. As Drs. Spevack and Chandra suggest, body height or an allometric measure of body height (e.g., height2.7) is, in our opinion, a better way to account for differences in body size. Indexing to lean body mass is an attractive option; however, this metric cannot be directly measured and is much more cumbersome to obtain than height. Interestingly, it is common to index left ventricular mass to height or height2.7, whereas left atrial and left ventricular volumes are conventionally indexed to body surface area. At a time when there is an increasing push for quantification of cardiac chamber sizes, we strongly support the notion that body surface area should be abandoned as a standard means of accounting for different body sizes.
- American College of Cardiology Foundation