Left ventricular (LV) hypertrophy is associated with cardiovascular complications and the geometry is important for prognosis. In some cardiovascular diseases, myocardial hypertrophy or dilation occurs regionally without modifying the global size of the heart. It is therefore relevant to determine regional normal reference values of the left ventricle. The aim of this study was to derive reference values of regional LV myocardial thickness (LVMT) and mass (LVMM) from a healthy study group of the general population using cardiac computed tomography angiography (CCTA). We wanted to introduce LV myocardial distribution (LVMD) as a measure of regional variation of the LVMT. Moreover, we wanted to determine whether these parameters varied between men and women. We studied 568 (181 men; 32%) adults, free of cardiovascular disease and risk factors, who underwent 320-detector CCTA. Mean age was 55 (range 40–84) years. Regional LVMT and LVMM were measured, according to the American Heart Association’s 17 segment model, using semi-automatic software. Mean LVMT were 6.6 mm for men and 5.4 mm for women (p < 0.001). The normal LV was thickest in the basal septum (segment 3; men = 8.3 mm; women = 7.2 mm) and thinnest in the mid-ventricular anterior wall (segment 7; men = 5.6 mm; women = 4.5 mm) for both men and women. However, the regional LVMD differed between men and women, with the LV being most heterogenic in women. The normal human LV is morphologically heterogenic, and showed same overall pattern but different regional distribution for men and women. This study introduces LVMD and provides gender specific reference values for regional LVMT, LVMM, and LVMD.
Cardiovascular computed tomography Left ventricular myocardium Dimensions Healthy population Reference values
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The research was supported financially by Snedkermester Sophus Jacobsen og hustru Astrids Jacobsens Fond and the Danish Heart Foundation (Grant No. 14-R97-A5017-22871). The authors wish to thank chief radiographer Kim Madsen, Department of Radiology and his staff of radiographers and nurses working at the scanner for their enthusiastic technical and logistical support.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest.
The Danish National Committee on Biomedical Research Ethics approved the research protocol (H-KF-01-144/01) and all patients gave oral and written consent before enrollment.
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