LV Mass and LVH

PHN 2D LV mass and wall Z scores (Lopez 2017, Table 2)

LVEDV    = 5/6 × LVEDA × LVEDL               (ml; cm² × cm)
LVEDVEPI = 5/6 × LVEDAEPI × LVEDLEPI
LVM      = 1.05 × (LVEDVEPI − LVEDV)          (g)
Z = (value / BSA^α − mean) / SD,  BSA = Haycock

            α     mean     SD
LVM        1.25   53.02    9.06
LVEDV      1.30   62.02   11.94
LVEDVEPI   1.30  113.14   17.85
LVMTV      0      0.88     0.16   (LVM / LVEDV, g/ml; not BSA-indexed)
LVST       0.40   0.58     0.09   (cm)
LVPWT      0.40   0.57     0.09   (cm)
LVEDD      0.45   3.89     0.33   (cm)
LVTTD      0      0.15     0.03   (LVPWT / LVEDD)

Coefficients verbatim from Lopez 2017 Table 2 (PMC5812349). The test suite matches ParameterZ's PHN calculator for LV mass, volumes, walls and ratios to 10⁻⁶. PHN measured walls and diameters on 2D short-axis images, not M-mode. Population: healthy, non-obese, term children aged 18 years or younger. PHN chose BSA over height for LV mass and excluded obese children, so in obesity a BSA-based Z score can understate hypertrophy.

M-mode LV mass and index

LVM (g)  = 0.8 × 1.04 × [(IVSd + LVIDd + LVPWd)³ − LVIDd³] + 0.6     (cm)
LVMI     = LVM / height[m]^2.7                                  (g/m^2.7)

The factor 0.8 and the +0.6 g are quoted from the Devereux 1986 abstract (“LV mass = 0.80 (ASE-cube LV mass) + 0.6 g”). The ASE-cube term 1.04 × [(IVSd + LVIDd + LVPWd)³ − LVIDd³] was not read in the Devereux full text. It is printed in open-access Schoenmaker 2013 and reproduces ParameterZ’s “ASE convention” result: 113.6 g and 38.0 g/m^2.7 for 0.8 / 4.5 / 0.8 cm at 150 cm, a value that is in the tests.

Khoury 2009 percentiles

M-mode LVM/height^2.7 in 2273 non-obese healthy children aged 0 to 18 years (Cincinnati). The cut-off is the paper’s 95th-quantile curve, printed in its Results (full text read; operators checked on the rendered page):

boys   LVMI95 = 77.5265 − age×15.8939 + age^1.5×5.2322 − age²×0.4671 + 2.7380
girls  LVMI95 = 77.5265 − age×15.8939 + age^1.5×5.2322 − age²×0.4671      (age in years)

Table 2’s empirical 95th percentile for the age band is shown alongside (boys / girls, g/m^2.7): < 6 mo 80.1 / 85.6; 6 mo–2 y 68.6 / 57.1; 2–4 y 52.4 / 55.3; 4–6 y 48.1 / 44.3; 6–8 y 44.6 / 43.5; 8–10 y 41.0 / 36.0; 10–12 y 38.2 / 35.7; 12–14 y 41.4 / 38.2; 14–16 y 40.5 / 36.9; 16 y and older 39.4 / 40.0.

Source conflict. The authors recommend > 45 g/m^2.7 (boys) and > 40 (girls) as abnormal above 9 years (abstract, Results, Discussion). Their own 95th-quantile curve and Table 2 are lower, especially for boys (curve 39.8 at 12 years, 42.4 at 18; Table 2 38.2–41.4). This page uses the curve, so it flags more children than the 45/40 rule; a value under 45 or 40 may still be above the age-specific 95th percentile. The 45/40 result is shown when it disagrees. Above the 95th percentile is not by itself a diagnosis of LVH. The curve reproduces ParameterZ’s Khoury upper limits in the verification cases.

Under 9 years. The authors caution that LVM/height^2.7 varies with age under 9 years (infant values are about double those of older children) and that another indexing method may suit young children better. The curve and Table 2 also differ by several g/m^2.7 in infancy (e.g. girls under 6 months: Table 2 85.6, curve 74–77).

Verification

Checked in October 2026: PHN 2D LV mass (grams and Z score) and LV end-diastolic volume Z agree with the official PHN calculator in 14 of 15 values (the one difference, an LVEDV Z at the second decimal, comes from that calculator’s BSA rounding). The M-mode results agree with ParameterZ’s LV mass calculator, an independent implementation, in 33 of 33 simulated children aged 0 to 18 years: Devereux LV mass, LV mass/height^2.7, the Khoury 2009 95th percentile and the above/not-above call. No calculator from the Khoury 2009 authors was used; the curve here is taken from the paper’s Results, and ParameterZ’s upper limits match it.

References

• Lopez L, Colan S, Stylianou M, et al. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979
• Khoury PR, Mitsnefes M, Daniels SR, Kimball TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009;22(6):709-714. doi:10.1016/j.echo.2009.03.003
• Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986;57(6):450-458. doi:10.1016/0002-9149(86)90771-x
• Schoenmaker NJ, van der Lee JH, Groothoff JW, et al. Low agreement between cardiologists diagnosing left ventricular hypertrophy in children with end-stage renal disease. BMC Nephrol 2013;14:170. doi:10.1186/1471-2369-14-170
• Haycock GB, Schwartz GJ, Wisotsky DH. J Pediatr 1978;93(1):62-66. doi:10.1016/S0022-3476(78)80601-5