Key result
Standard Human Index outperforms traditional BSA in detecting biventricular volume increases among overweight and obese patients.
Why the study?
To examine relationships among body size, age, and biventricular volume using the novel Standard Human Index to better discriminate increased volume in overweight and obese patients.
Does the Standard Human Index (SHI) improve the discrimination of increased biventricular volume in overweight and obese patients compared to BSA indexing?
Does the Standard Human Index (SHI) improve the discrimination of increased biventricular volume in overweight and obese patients compared to BSA indexing?
The novel Standard Human Index (SHI) provides better discrimination of biventricular volume increases in overweight and obese patients on non-contrast CT compared to traditional BSA indexing.
Requires caution with BSA for biventricular volumes in obesity; hypothesis-generating for SHI pending validation.
Background/Objectives: Biventricular volume (BVV) can be measured from non-contrast-enhanced CT images in patients undergoing coronary artery calcium (CAC) scoring. BVV correlates with left ventricular mass and may predict mortality risk in type 2 diabetes mellitus patients. This study examines the relationships among body size, age, and BVV using the Standard Human Index (SHI), which combines height and bodyprint (BP = k × height − body surface area, h-BSA; k = 1 for females, 1.1 for males). We hypothesize that this novel indexing method enhances the discrimination of increased BVV in overweight and obese patients and assesses the relevance of age in interpreting BVV changes. Methods: We analyzed CT data from 2466 patients (1606 women, 860 men; mean age 64 ± 11 years) referred for CAC scoring. Fatless BVV was measured semi-automatically, and we compared raw BVV values and BVV normalized for height, body surface area (BSA), and the SHI across sex, age, and body mass index (BMI) categories. Results: BVV was significantly higher in males (414 ± 97 mL) than females (297 ± 66 mL) (p < 0.001). BVV decreased non-linearly with age, stabilizing in older patients. Normal-weight males had higher BVV than females (p < 0.001). Normalization for height, BSA, and the SHI indicated that BSA did not effectively distinguish BVV changes in overweight and obese patients. Conclusions: The proposed index effectively diagnosed BVV increases in overweight individuals, while BSA indexing may be misleading. The age dependence of BVV challenges the validity of standards based on younger populations for detecting ventricular enlargement in older adults.
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Sosnowski et al. (2026) studied this question. The novel Standard Human Index effectively detected biventricular volume increases in overweight and obese individuals, whereas traditional body surface area indexing proved misleading.
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