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Abstract

Several formulae for the estimation of body surface area (BSA) are used in the medical literature to index a number of biological variables including left ventricular mass (LVM). Most authors estimate BSA using the 1916 Dubois formula {(Weight, kg) 0.425* (Height, cm)0.725* 0.007184} which was developed in only 9 patients. Other formulae such as those by Gehan {(Weight, kg) 0.51456* (Height, cm)0.42246* 0.02350} and Mosteller {[(Height, cm) * (Weight, kg) ÷ 3600]0.5} were developed in a larger number of subjects but are infrequently used in the cardiology literature. We examined the effects of different methods of LVM indexation to BSA on relationships between LVM index and ambulatory blood pressure. A group of hypertensive (60) and normotensives (32) patients in the untreated state were systematically examined. The three methods of LVM indexation gave similar correlation coefficients of LVMI with ambulatory blood pressure averages with only minor differences (range 0.32 to .42, ± 0.22). However, the different formulae gave very different limits of agreement indicating the lack of interchangeability of the 3 formulae.These results show that different formulae for BSA when used to index LVM may cause important differences in the limits of agreement. Researchers should be explicit about formulae used for calculations of BSA in studies of LVM. Further study is needed regarding the scientific accuracy of the different formulae to estimate BSA and the optimal formulae in obese subjects, children, or patients with skeletal disorders. (See Table)

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Bland-Altman limits of LVMI agreement calculated using 3 formulae for BSA.

mean difference±2 SDRange
Dubois-Mosteller+1.2+2.3 to +4.7−3.6 to +8.7
Dubois-Gehan+2.3+2.2 to +6.9−3.4 to +12.8
Mosteller-Gehan−1.1−.01 to +2.27−4.1 to −.20
mean difference±2 SDRange
Dubois-Mosteller+1.2+2.3 to +4.7−3.6 to +8.7
Dubois-Gehan+2.3+2.2 to +6.9−3.4 to +12.8
Mosteller-Gehan−1.1−.01 to +2.27−4.1 to −.20
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Bland-Altman limits of LVMI agreement calculated using 3 formulae for BSA.

mean difference±2 SDRange
Dubois-Mosteller+1.2+2.3 to +4.7−3.6 to +8.7
Dubois-Gehan+2.3+2.2 to +6.9−3.4 to +12.8
Mosteller-Gehan−1.1−.01 to +2.27−4.1 to −.20
mean difference±2 SDRange
Dubois-Mosteller+1.2+2.3 to +4.7−3.6 to +8.7
Dubois-Gehan+2.3+2.2 to +6.9−3.4 to +12.8
Mosteller-Gehan−1.1−.01 to +2.27−4.1 to −.20

Body Surface Area, Left Ventricular Mass, Hypertension
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© American Journal of Hypertension, Ltd. 2002
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