Ventricular structure

Left Ventricle (LV)

Diameter

  1. Longitudinal diameter

    • Definition: Distance between the mitral valve plane and the LV apex (major axis)(Aquaro et al. 2017)

    • Acquisition Type: SAX, LAX

    • Reference Range:

      • End-diastolic:

        StudyCohort SizeImaging modalityGenderAgeReference Value (mm)Note
        (Aquaro et al. 2017)28HLAmale41-5091-112
        29HLAmale51-6087-111
        28HLAmale>6085-110
        23HLAfemale41-5080-100
        22HLAfemale51-6075-99
        23HLAfemale>6067-96

        Note: The extracted phenotypes are smaller than the reference ranges, as we only reach the uppermost part of mitral valve, instead of the plane of mitral valve.

    • Clinical Associations: Increased in hypertrophic obstructive cardiomyopathy (HOCM) (Bi et al. 2022)

    • ICC:

      • End-diastolic: 0.80 (HLA)

      • End-systolic: Note: 0.41 (HLA)

  2. Transversal diameter

    • Definition: Distance between the basal inferior septum and basal anterolateral wall(Aquaro et al. 2017)

    • Acquisition Type: SAX, LAX

    • Reference Range:

      • End-diastolic:

        StudyCohort SizeImaging modalityGenderReference Value (mm)Note
        (Kawel-Boehm et al. 2020)227HLAmale42-62
        188HLAfemale39-59
        400SAXmale44-62
        572SAXfemale41-57
      • End-systolic:

        StudyCohort SizeImaging modalityGenderReference Value (mm)Note
        (Kawel-Boehm et al. 2020)54HLAmale26-38
        53HLAfemale16-40
        60SAXmale28-40
        60SAXfemale23-39
    • ICC:

      • End-diastolic: 0.71 (SAX), 0.65 (HLA)

      • End-systolic: 0.75 (SAX), 0.55 (HLA)

    <figure> <img src="/latex/images/ventricle/LV_diameter.png" id="fig:LV_diameter" alt="Measurement of longitudinal and transversal diameters in a healthy male (upper panel) and female (lower panel) in HLA view" /><figcaption aria-hidden="true">Measurement of longitudinal and transversal diameters in a healthy male (upper panel) and female (lower panel) in HLA view</figcaption> </figure>

Volume (LVEDV, LVESV)

Graphically, the cardiac cycle can be represented with a pressure-volume graph shown below. The electrical and mechanical events during the cardiac cycle are summarised together in the Wiggers diagram below.

<figure> <img src="/latex/images/ventricle/pressure-volume%20change.png" id="fig:wigger" alt="The Wiggers diagram follows left heart and aortic pressures, left ventricular volume, and the ECG through one cardiac cycle. (Silverthorn et al. 2013)" /><figcaption aria-hidden="true">The Wiggers diagram follows left heart and aortic pressures, left ventricular volume, and the ECG through one cardiac cycle. <span>(Silverthorn et al. 2013)</span></figcaption> </figure>

<figure> <img src="/latex/images/ventricle/Wigger%27s%20Diagram.png" id="fig:wigger" alt="The Wiggers diagram follows left heart and aortic pressures, left ventricular volume, and the ECG through one cardiac cycle. (Silverthorn et al. 2013)" /><figcaption aria-hidden="true">The Wiggers diagram follows left heart and aortic pressures, left ventricular volume, and the ECG through one cardiac cycle. <span>(Silverthorn et al. 2013)</span></figcaption> </figure>

At the end of atrial systole in the cardiac cycle, the ventricle contain the largest volume they will hold during the cycle. This maximal volume is called the end-diastolic volume (EDV). As the ventricles contrast, the heart does not empty itself completely of blood each time the ventricle contracts. The volume of blood left in the ventricle at the end of contraction is known as the end-systolic volume (ESV) (Silverthorn et al. 2013).

  • Definition: Volume of LV cavity.

  • Calculation:

    Two approaches are frequently adopted for measuring the volume: Simpson’s rule and area-length method (ALM).

    1. In Simpson’s rule, the volume of a cavity is estimated by the sum of the cross-sectional area of multiple single slices multiplied by the slice thickness (Hergan et al. 2008).

    2. The ALM method is based on a rotational ellipsoid with the volume calculated as V = 0.85 × A<sup>2</sup>/L for area A and length L (Hergan et al. 2008).

    Other algorithms for determining the LV volume, such as the modified Simpson’s rule, can be found in (Folland et al. 1979)

  • Acquisition Type: SAX, LAX

  • Reference Range:

    • End-diastolic:

      StudyCohort SizeGenderReference Value (mL)Note
      (Kawel-Boehm et al. 2020)464male(155, 30)papillary muscles included in mass
      485female(123, 22)papillary muscles included in mass
      832male(145, 31)papillary muscles included in volume
      1064female(112, 21)papillary muscles included in volume
      (Hudsmith et al. 2005)63male(160, 29)
      45female(135, 26)
      (Suinesiaputra et al. 2018)4413(144, 34.3)48% male in full cohort with size 4874
      (Petersen et al. 2017)368male109-218
      432female88-161
    • End-systolic:

      StudyCohort SizeGenderReference Value (mL)Note
      (Kawel-Boehm et al. 2020)464male(55, 15)papillary muscles included in mass
      485female(43, 11)papillary muscles included in mass
      832male(53, 18)papillary muscles included in volume
      1064female(39, 12)papillary muscles included in volume
      (Hudsmith et al. 2005)63male(50, 16)
      45female(42, 12)
      (Suinesiaputra et al. 2018)4413(59.2 20.3)48% male in full cohort with size 4874
      (Petersen et al. 2017)368male39-97
      432female31-68
  • Clinical Associations: The indexed end-diastolic volume is decreased in type 2 diabetic patients (T2DM) (Shang et al. 2018). The indexed end-diastolic volume is greater in patients with HOCM (Bi et al. 2022).

  • ICC:

    • End-diastolic: 0.91

    • End-systolic: 0.87

Mass (LVM)

The mass of LV myocardium is usually derived by multiplying the LV volume with the clinically-accepted value 1.05 g/mL or 1.055 g/mL (Myerson, Bellenger, and Pennell 2002; Fuchs et al. 2012, 2016; Bai et al. 2018).

  • Definition: Mass of myocardium

  • Calculation: LVM = LVEDV × 1.05

  • Acquisition Type: SAX, LAX

  • Reference Range:

    • End-diastolic:

      StudyCohort SizeGenderAgeReference Value (g)Note
      (Kawel-Boehm et al. 2020)464male(121, 28)papillary muscles included in mass
      485female(83, 21)papillary muscles included in mass
      832male(105, 24)papillary muscles included in volume
      1064female(73, 15)papillary muscles included in volume
      (Hudsmith et al. 2005)63male(123, 21)
      45female(96, 27)
      (Suinesiaputra et al. 2018)4413(59.2 20.3)48% male in full cohort with size 4874
      (Petersen et al. 2017)368male64-141
      432female46-93
      (Ruijsink et al. 2020)304male45-5471-137
      384male55-6473-126
      241male65-7474-123
      297female45-5451-91
      322female55-6452-87
      213female65-7454-86
      (Le Ven et al. 2016)196male(125, 25)average age 26.7 years
      238female(82, 15)average age 25.8 years
  • Clinical Associations: Increased LV mass is a strong predictor of LAA thrombus in persistent AF (Boyd et al. 2013), HOCM (Bi et al. 2022), and incident HF (Bluemke et al. 2008).

  • ICC:

    • End-diastolic: 0.97

Mass/Volume (M/V)

As LVH can occur either through ventricular dilation or wall thickening, a 4-tiered classification of LVH using both LVEDV and concentricity are developed to provide prognostic information beyond simple measure of LV mass. The concentricity can be measured using either mass/volume (M/V), or M/V<sup>0.67</sup> (Khouri et al. 2010).

  • Definition: The ratio of LV mass and LVEDV.

  • Calculation: M/V = LVM/LVEDV

  • Acquisition Type: SAX, LAX

  • Reference Range:

    • End-diastolic:

      StudyCohort SizeReference Value (g/mL)Note
      (Khouri et al. 2010)1908(1.6, 0.3)53% male in cohort
  • Clinical Associations: Increased LV mass is a strong predictor of LAA thrombus in persistent AF (Boyd et al. 2013), HOCM (Bi et al. 2022), and incident HF (Bluemke et al. 2008). Patients with hypertension tend to have both elevated LV mass and M/V ratio (Yoneyama et al. 2012; Méndez et al. 2018), a pattern that also extends to individuals with incident coronary heart disease (CHD) and stroke (Bluemke et al. 2008). T2DM patients show increased M/V ratios relative to healthy controls (Shang et al. 2018). The M/V ratio also serves as a useful metric for differentiating physiological hypertrophy in athletes from pathological hypertrophy seen in HCM (Méndez et al. 2018).

  • ICC: 0.82

Sphericity Index

The extent of LV shape abnormality can be graded by defining an index of sphericity called the sphericity index (Lamas et al. 1989).

  • Definition: LV volume divided by the volume of of a sphere whose diameter is equal to the LV longitudinal diameter (major axis of the ventricle) (Lamas et al. 1989; Kono et al. 1991; Aquaro et al. 2017).

  • Acquisition Type: SAX, LAX

  • Reference Range:

    • End-diastolic:

      StudyCohort SizeGenderAgeReference ValueNote
      (Kono et al. 1991)8(0.25, 0.01)5 males, 3 females
      (Aquaro et al. 2017)33male16-200.22-0.40
      27male21-300.24-0.40
      28male31-400.23-0.40
      28male41-500.24-0.40
      29male51-600.23-0.40
      28male>600.26-0.40
      20female16-200.24-0.41
      24female21-300.22-0.40
      23female31-400.23-0.42
      23female41-500.20-0.42
      22female51-600.26-0.42
      23female>600.31-0.42
      (A. Maceira et al. 2006)10male40-490.22-0.47
      10male50-590.22-0.48
      10male60-690.23-0.48
      10male70-790.23-0.49
      10female40-490.27-0.53
      10female50-590.27-0.53
      10female60-690.27-0.53
      10female70-790.27-0.53

      Note: The extracted phenotypes are larger than the reference ranges, as the diameters are smaller than the reference range.

    • End-systolic:

      StudyCohort SizeGenderAgeReference ValueNote
      (Kono et al. 1991)8(0.14, 0.01)5 males, 3 females
      (A. Maceira et al. 2006)10male40-490.10-0.30
      10male50-590.09-0.29
      10male60-690.08-0.28
      10male70-790.07-0.27
      10female40-490.10-0.37
      10female50-590.08-0.35
      10female60-690.06-0.33
      10female70-790.04-0.31
  • Clinical Associations: Both end-diastolic and end-systolic sphericity index are higher in patients with mitral regurgitation (MR) (Kono et al. 1991).

  • ICC:

    • End-diastolic: Note: 0.47

    • End-systolic: Note: 0.14

<figure> <img src="/latex/images/ventricle/sphericity_index.png" id="fig:LV_sphericity_index" alt="Scheme of calculation of sphericity index. The sphericity index is defined as the ratio in percentage between LV volume and the volume of the sphere (Aquaro et al. 2017)" /><figcaption aria-hidden="true">Scheme of calculation of sphericity index. The sphericity index is defined as the ratio in percentage between LV volume and the volume of the sphere <span>(Aquaro et al. 2017)</span></figcaption> </figure>

Right Ventricle (RV)

Although the importance of RV function has been neglected for decades, accumulating evidence has proven its dramatic clinical relevance (Muraru et al. 2022).

Volume

  • Acquisition Type: SAX, LAX

  • Reference Range:

    • End-diastolic:

      StudyCohort SizeGenderAgeReference Value (mL)Note
      (A. M. Maceira et al. 2006)10male20-29127-227
      10male30-39121-221
      10male40-49116-216
      10male50-59111-210
      10male60-69105-205
      10male70-79100-200
      10female20-29100-184
      10female30-3994-178
      10female40-4987-172
      10female50-5981-166
      10female60-6975-160
      10female70-7969-153
      (Kawel-Boehm et al. 2020)896male(166, 39)
      977female(122, 27)
      (Petersen et al. 2017)368male124-248
      432female85-168
    • End-systolic:

      StudyCohort SizeGenderAgeReference Value (mL)Note
      (A. M. Maceira et al. 2006)10male20-2938-98
      10male30-3934-94
      10male40-4929-89
      10male50-5925-85
      10male60-6920-80
      10male70-7916-76
      10female20-2929-82
      10female30-3925-77
      10female40-4920-72
      10female50-5915-68
      10female60-6911-63
      10female70-796-58
      (Kawel-Boehm et al. 2020)896male(73, 22)
      977female(50, 15)
      (Petersen et al. 2017)368male47-123
      432female27-77
  • Clinical Associations: RV is less dilated and hypertrophied in patients with HFpEF compared with HFpEF-PH than those with PAH (Van Wezenbeek et al. 2022). Adults with Ebstein’s anomaly often present with right ventricular (RV) dilation, as evidenced by increased indexed RV end-diastolic volume (Lee et al. 2013).

  • ICC:

    • End-diastolic: 0.92

    • End-systolic: 0.92

Mass

  • Acquisition Type: SAX, LAX

  • Reference Range:

    StudyCohort SizeGenderAgeReference Value (g)Note
    (A. M. Maceira et al. 2006)10male20-2942-99
    10male30-3940-97
    10male40-4939-95
    10male50-5937-94
    10male60-6935-92
    10male70-7933-90
    10female20-2933-74
    10female30-3931-72
    10female40-4928-70
    10female50-5926-68
    10female60-6924-66
    10female70-7922-63

<div id="refs" class="references csl-bib-body hanging-indent">

<div id="ref-aquaroReferenceValuesCardiac2017" class="csl-entry">

Aquaro, Giovanni Donato, Giovanni Camastra, Lorenzo Monti, Massimo Lombardi, Alessia Pepe, Silvia Castelletti, Viviana Maestrini, et al. 2017. “Reference Values of Cardiac Volumes, Dimensions, and New Functional Parameters by MR: A Multicenter, Multivendor Study.” Journal of Magnetic Resonance Imaging 45 (4): 1055–67.

</div>

<div id="ref-baiAutomatedCardiovascularMagnetic2018a" class="csl-entry">

Bai, Wenjia, Matthew Sinclair, Giacomo Tarroni, Ozan Oktay, Martin Rajchl, Ghislain Vaillant, Aaron M. Lee, et al. 2018. “Automated Cardiovascular Magnetic Resonance Image Analysis with Fully Convolutional Networks.” Journal of Cardiovascular Magnetic Resonance 20 (1): 65.

</div>

<div id="ref-biSexDifferencesAtrial2022" class="csl-entry">

Bi, Xuanye, Yanyan Song, Chengzhi Yang, Yunhu Song, Shihua Zhao, Shubin Qiao, and Jinying Zhang. 2022. “Sex Differences in Atrial Remodeling and Its Relationship with Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy.” Frontiers in Cardiovascular Medicine 9: 947975.

</div>

<div id="ref-bluemkeRelationshipLeftVentricular2008" class="csl-entry">

Bluemke, David A., Richard A. Kronmal, João A. C. Lima, Kiang Liu, Jean Olson, Gregory L. Burke, and Aaron R. Folsom. 2008. “The Relationship of Left Ventricular Mass and Geometry to Incident Cardiovascular Events: The MESA Study.” Journal of the American College of Cardiology 52 (25): 2148–55.

</div>

<div id="ref-boydLeftVentricularMass2013" class="csl-entry">

Boyd, A. C., T. McKay, S. Nasibi, D. A. B. Richards, and L. Thomas. 2013. “Left Ventricular Mass Predicts Left Atrial Appendage Thrombus in Persistent Atrial Fibrillation.” European Heart Journal - Cardiovascular Imaging 14 (3): 269–75.

</div>

<div id="ref-follandAssessmentLeftVentricular1979" class="csl-entry">

Folland, E D, A F Parisi, P F Moynihan, D R Jones, C L Feldman, and D E Tow. 1979. “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time, Two-Dimensional Echocardiography. A Comparison of Cineangiographic and Radionuclide Techniques.” Circulation 60 (4): 760–66.

</div>

<div id="ref-fuchsAutomatedAssessmentHeart2012" class="csl-entry">

Fuchs, Andreas, Jørgen Tobias Kühl, Jacob Lønborg, Thomas Engstrøm, Niels Vejlstrup, Lars Køber, and Klaus F. Kofoed. 2012. “Automated Assessment of Heart Chamber Volumes and Function in Patients with Previous Myocardial Infarction Using Multidetector Computed Tomography.” Journal of Cardiovascular Computed Tomography 6 (5): 325–34.

</div>

<div id="ref-fuchsNormalValuesLeft2016" class="csl-entry">

Fuchs, Andreas, Mads R. Mejdahl, J. Tobias Kühl, Zara R. Stisen, Emma Julia P. Nilsson, Lars V. Køber, Børge G. Nordestgaard, and Klaus F. Kofoed. 2016. “Normal Values of Left Ventricular Mass and Cardiac Chamber Volumes Assessed by 320-Detector Computed Tomography Angiography in the Copenhagen General Population Study.” European Heart Journal – Cardiovascular Imaging 17 (9): 1009–17.

</div>

<div id="ref-herganComparisonLeftRight2008" class="csl-entry">

Hergan, Klaus, Antonius Schuster, Julia Frühwald, Michael Mair, Ralph Burger, and Michael Töpker. 2008. “Comparison of Left and Right Ventricular Volume Measurement Using the Simpson’s Method and the Area Length Method.” European Journal of Radiology 65 (2): 270–78.

</div>

<div id="ref-hudsmith+NormalHumanLeft2005" class="csl-entry">

Hudsmith, Lucy, Steffen Petersen, Jane Francis, Matthew Robson, and Stefan Neubauer. 2005. “Normal Human Left and Right Ventricular and Left Atrial Dimensions Using Steady State Free Precession Magnetic Resonance Imaging.” Journal of Cardiovascular Magnetic Resonance 7 (5): 775–82.

</div>

<div id="ref-kawel-boehmReferenceRangesNormal2020" class="csl-entry">

Kawel-Boehm, Nadine, Scott J. Hetzel, Bharath Ambale-Venkatesh, Gabriella Captur, Christopher J. Francois, Michael Jerosch-Herold, Michael Salerno, et al. 2020. “Reference Ranges (‘Normal Values’) for Cardiovascular Magnetic Resonance (CMR) in Adults and Children: 2020 Update.” Journal of Cardiovascular Magnetic Resonance 22 (1): 87.

</div>

<div id="ref-khouri4TieredClassificationLeft2010" class="csl-entry">

Khouri, Michel G., Ronald M. Peshock, Colby R. Ayers, James A. De Lemos, and Mark H. Drazner. 2010. “A 4-Tiered Classification of Left Ventricular Hypertrophy Based on Left Ventricular Geometry: The Dallas Heart Study.” Circulation: Cardiovascular Imaging 3 (2): 164–71.

</div>

<div id="ref-konoLeftVentricularShape1991" class="csl-entry">

Kono, Tatsuji, Hani N. Sabbah, Paul D. Stein, James F. Brymer, and Fareed Khaja. 1991. “Left Ventricular Shape as a Determinant of Functional Mitral Regurgitation in Patients with Severe Heart Failure Secondary to Either Coronary Artery Disease or Idiopathic Dilated Cardiomyopathy.” The American Journal of Cardiology 68 (4): 355–59.

</div>

<div id="ref-lamasEffectsLeftVentricular1989" class="csl-entry">

Lamas, Gervasio A., Douglas E. Vaughan, Alfred F. Parisi, and Marc A. Pfeffer. 1989. “Effects of Left Ventricular Shape and Captopril Therapy on Exercise Capacity After Anterior Wall Acute Myocardial Infarction.” The American Journal of Cardiology 63 (17): 1167–73.

</div>

<div id="ref-levenCardiacMorphologyFunction2016" class="csl-entry">

Le Ven, Florent, Karine Bibeau, Élianne De Larochellière, Helena Tizón-Marcos, Stéphanie Deneault-Bissonnette, Philippe Pibarot, Christian F. Deschepper, and Éric Larose. 2016. “Cardiac Morphology and Function Reference Values Derived from a Large Subset of Healthy Young Caucasian Adults by Magnetic Resonance Imaging.” European Heart Journal Cardiovascular Imaging 17 (9): 981–90.

</div>

<div id="ref-leeShapeFunctionRight2013" class="csl-entry">

Lee, Christopher M., Florence H. Sheehan, Beatriz Bouzas, Sylvia S. M. Chen, Michael A. Gatzoulis, and Philip J. Kilner. 2013. “The Shape and Function of the Right Ventricle in Ebstein’s Anomaly.” International Journal of Cardiology 167 (3): 704–10.

</div>

<div id="ref-maceiraReferenceRightVentricular2006" class="csl-entry">

Maceira, A. M., S. K. Prasad, M. Khan, and D. J. Pennell. 2006. “Reference Right Ventricular Systolic and Diastolic Function Normalized to Age, Gender and Body Surface Area from Steady-State Free Precession Cardiovascular Magnetic Resonance.” European Heart Journal 27 (23): 2879–88. https://doi.org/10.1093/eurheartj/ehl336.

</div>

<div id="ref-maceiraNormalizedLeftVentricular2006" class="csl-entry">

Maceira, A., S. Prasad, M. Khan, and D. Pennell. 2006. “Normalized Left Ventricular Systolic and Diastolic Function by Steady State Free Precession Cardiovascular Magnetic Resonance.” Journal of Cardiovascular Magnetic Resonance 8 (3): 417–26.

</div>

<div id="ref-mendezDifferentialDiagnosisThickened2018" class="csl-entry">

Méndez, Cristina, Rafaela Soler, Esther Rodríguez, Roberto Barriales, Juan Pablo Ochoa, and Lorenzo Monserrat. 2018. “Differential Diagnosis of Thickened Myocardium: An Illustrative MRI Review.” Insights into Imaging 9 (5): 695–707.

</div>

<div id="ref-muraruRightVentricularLongitudinal2022" class="csl-entry">

Muraru, Denisa, Kristina Haugaa, Erwan Donal, Ivan Stankovic, Jens Uwe Voigt, Steffen E Petersen, Bogdan A Popescu, and Thomas Marwick. 2022. “Right Ventricular Longitudinal Strain in the Clinical Routine: A State-of-the-Art Review.” European Heart Journal - Cardiovascular Imaging 23 (7): 898–912. https://doi.org/10.1093/ehjci/jeac022.

</div>

<div id="ref-myersonAssessmentLeftVentricular2002" class="csl-entry">

Myerson, Saul G., Nicholas G. Bellenger, and Dudley J. Pennell. 2002. “Assessment of Left Ventricular Mass by Cardiovascular Magnetic Resonance.” Hypertension 39 (3): 750–55.

</div>

<div id="ref-petersenReferenceRangesCardiac2017" class="csl-entry">

Petersen, Steffen E., Nay Aung, Mihir M. Sanghvi, Filip Zemrak, Kenneth Fung, Jose Miguel Paiva, Jane M. Francis, et al. 2017. “Reference Ranges for Cardiac Structure and Function Using Cardiovascular Magnetic Resonance (CMR) in Caucasians from the UK Biobank Population Cohort.” Journal of Cardiovascular Magnetic Resonance 19 (1): 18.

</div>

<div id="ref-ruijsinkFullyAutomatedQualityControlled2020" class="csl-entry">

Ruijsink, Bram, Esther Puyol-Antón, Ilkay Oksuz, Matthew Sinclair, Wenjia Bai, Julia A. Schnabel, Reza Razavi, and Andrew P. King. 2020. “Fully Automated, Quality-Controlled Cardiac Analysis From CMR: Validation and Large-Scale Application to Characterize Cardiac Function.” JACC: Cardiovascular Imaging 13 (3): 684–95.

</div>

<div id="ref-shangLeftAtriumPassive2018" class="csl-entry">

Shang, Yongning, Xiaochun Zhang, Weiling Leng, Xiaotian Lei, Liu Chen, Ziwen Liang, and Jian Wang. 2018. “Left Atrium Passive Ejection Fraction Is the Most Sensitive Index of Type 2 Diabetes Mellitus-Related Cardiac Changes.” The International Journal of Cardiovascular Imaging 34 (1): 141–51.

</div>

<div id="ref-silverthorn2013human" class="csl-entry">

Silverthorn, Dee Unglaub, William C Ober, Claire W Garrison, Andrew C Silverthorn, and Bruce R Johnson. 2013. Human Physiology: An Integrated Approach. Vol. 3. Pearson Education Indianapolis, IN.

</div>

<div id="ref-suinesiaputraFullyautomatedLeftVentricular2018" class="csl-entry">

Suinesiaputra, Avan, Mihir M. Sanghvi, Nay Aung, Jose Miguel Paiva, Filip Zemrak, Kenneth Fung, Elena Lukaschuk, et al. 2018. “Fully-Automated Left Ventricular Mass and Volume MRI Analysis in the UK Biobank Population Cohort: Evaluation of Initial Results.” The International Journal of Cardiovascular Imaging 34 (2): 281–91.

</div>

<div id="ref-vanwezenbeekRightVentricularRight2022" class="csl-entry">

Van Wezenbeek, Jessie, Azar Kianzad, Arno Van De Bovenkamp, Jeroen Wessels, Sophia A. Mouratoglou, Natalia J. Braams, Samara M. A. Jansen, et al. 2022. “Right Ventricular and Right Atrial Function Are Less Compromised in Pulmonary Hypertension Secondary to Heart Failure With Preserved Ejection Fraction: A Comparison With Pulmonary Arterial Hypertension With Similar Pressure Overload.” Circulation: Heart Failure 15 (2): e008726. https://doi.org/10.1161/CIRCHEARTFAILURE.121.008726.

</div>

<div id="ref-yoneyamaAgeSexHypertensionRelated2012" class="csl-entry">

Yoneyama, Kihei, Ola Gjesdal, Eui-Young Choi, Colin O. Wu, W. Gregory Hundley, Antoinette S. Gomes, Chia-Ying Liu, Robyn L. McClelland, David A. Bluemke, and Joao A. C. Lima. 2012. “Age, Sex, and Hypertension-Related Remodeling Influences Left Ventricular Torsion Assessed by Tagged Cardiac Magnetic Resonance in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis.” Circulation 126 (21): 2481–90.

</div>

</div>