title: Gender differences and normal left ventricular anatomy in an adult population free of hypertension. A cardiovascular magnetic resonance study of the Framingham Heart Study Offspring cohort.
abstract: OBJECTIVE
  We sought to derive gender-specific cardiovascular magnetic resonance (CMR) reference values for normative left ventricular (LV) anatomy and function in a healthy adult population of clinically relevant age.
  
  
  BACKGROUND
  Cardiovascular magnetic resonance imaging is increasingly applied in the clinical setting, but age-relevant, gender-specific normative values are currently unavailable.
  
  
  METHODS
  A representative sample of 318 Framingham Heart Study (FHS) Offspring participants free of clinically overt cardiovascular disease underwent CMR examination to determine LV end-diastolic and end-systolic volume (EDV and ESV, respectively), mass, ejection fraction (EF) and linear dimensions (wall thickness, cavity length). Subjects with a clinical history of hypertension or those with a systolic blood pressure > or =140 mm Hg or diastolic pressure > or =90 mm Hg at any FHS cycle examination were excluded, leaving 142 subjects (63 men, 79 women; age 57 +/- 9 years).
  
  
  RESULTS
  All volumetric (EDV, ESV, mass) and unidimensional measures were significantly greater (p < 0.001) in men than in women and remained greater (p < 0.02) after adjustment for subject height. Volumetric measures were greater (p < 0.001) in men than in women after adjustment for body surface area (BSA), but there were increased linear dimensions in women after adjustment for BSA. In particular, end-diastolic dimension indexed to BSA was greater in women (p < 0.001) than in men. There were no gender differences in global LVEF (men = 0.69; women = 0.70).
  
  
  CONCLUSIONS
  Cardiovascular magnetic resonance measures of LV volumes, mass and linear dimensions differ significantly according to gender and body size. This study provides gender-specific normal CMR reference values, uniquely derived from a population-based sample of persons free of cardiovascular disease and clinical hypertension. These data may serve as a reference to identify LV pathology in the adult population.
authors.affiliation: Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of the Department of Medicine, Boston, Massachusetts, USA.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Salton
authors.forename: Michael L
authors.initials: ML
authors.lastname: Chuang
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Kupka
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Kraig V
authors.initials: KV
authors.lastname: Kissinger
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edelman
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology