{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:49:29Z","timestamp":1773931769069,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u00d7 height \u2212 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 \u00b1 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 \u00b1 97 mL) than females (297 \u00b1 66 mL) (p &lt; 0.001). BVV decreased non-linearly with age, stabilizing in older patients. Normal-weight males had higher BVV than females (p &lt; 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.<\/jats:p>","DOI":"10.3390\/jcm15062350","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:50:36Z","timestamp":1773921036000},"page":"2350","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Detection of Biventricular Volume Increase in Overweight and Obese Individuals Using a Novel Index of the \u201cStandard Human\u201d\u2014A Single-Center, Non-Contrast-Enhanced Cardiac CT Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1473-8316","authenticated-orcid":false,"given":"Maciej","family":"Sosnowski","sequence":"first","affiliation":[{"name":"Unit of Noninvasive Cardiovascular Diagnostics, 3rd Chair of Cardiology, Faculty of Medical Science in Katowice, Medical University of Silesia, Ziolowa Str 47, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3681-5207","authenticated-orcid":false,"given":"Wojciech","family":"Wojakowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Structural Heart Disease, 3rd Chair of Cardiology, Faculty of Medical Science in Katowice, Medical University of Silesia, Ziolowa Str 47, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Harpula","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Structural Heart Disease, 3rd Chair of Cardiology, Faculty of Medical Science in Katowice, Medical University of Silesia, Ziolowa Str 47, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Lepich","sequence":"additional","affiliation":[{"name":"Department of Normal Anatomy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Ziolowa Str 47, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/ejhf.3024","article-title":"2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA)","volume":"26","author":"McDonagh","year":"2024","journal-title":"Eur. J. Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chaudhari, M., and Ashwath, M.L. (2025). Cardiac Imaging in the Diagnosis and Management of Heart Failure. J. Clin. Med., 14.","DOI":"10.3390\/jcm14145002"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S0140-6736(12)60397-3","article-title":"Hypertrophic cardiomyopathy","volume":"381","author":"Maron","year":"2013","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.15420\/cfr.2018.41.2","article-title":"Aortic stenosis and heart failure: Disease ascertainment and statistical considerations for clinical trials","volume":"5","author":"Spitzer","year":"2019","journal-title":"Card. Fail. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal definition and classification of heart failure: A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the universal definition of heart failure","volume":"27","author":"Bozkurt","year":"2021","journal-title":"J. Card. Fail."},{"key":"ref_7","first-page":"715","article-title":"Management of ventricular arrhythmias worldwide: Comparison of the latest ESC, AHA\/ACC\/HRS, and CCS\/CHRS Guidelines","volume":"9","author":"Ellermann","year":"2023","journal-title":"JACC Clin. Eelectrophysiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jcmg.2020.07.032","article-title":"Lower cardiorespiratory fitness is associated with a smaller and stiffer heart: The sedentary\u2019s heart","volume":"14","author":"Markus","year":"2021","journal-title":"J. Am. Coll. Cardiol. Img"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Loh, D.R., Tan, R.S., Lim, W.S., and Koh, A.S. (2022). Cardio-sarcopenia: A syndrome of concern in aging. Front. Med., 9.","DOI":"10.3389\/fmed.2022.1027466"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/s13098-025-01939-7","article-title":"Small left ventricular size as a predictor for incident type 2 diabetes: Insights from the UK biobank cardio-vascular magnetic resonance substudy","volume":"17","author":"Hu","year":"2025","journal-title":"Diabet. Metab. Syndr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101444","DOI":"10.1016\/j.jacadv.2024.101444","article-title":"Small heart size and premature death in 366,484 individuals with normal ejection fraction","volume":"4","author":"Rowe","year":"2025","journal-title":"JACC Adv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jacc.2004.09.054","article-title":"Diastolic dysfunction and left atrial volume: A population-based study","volume":"45","author":"Pritchett","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1161\/HYPERTENSIONAHA.114.03975","article-title":"Prognostic significance of left atrial enlargement in a general population: Results of the PAMELA study","volume":"64","author":"Bombelli","year":"2014","journal-title":"Hypertension"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12968-018-0517-0","article-title":"Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: A multicenter study","volume":"21","author":"Khan","year":"2019","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1002\/ejhf.822","article-title":"Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland","volume":"19","author":"Mamas","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cardfail.2024.07.001","article-title":"WRITING COMMITTEE MEMEBERS. HF STATS 2024: Heart failure epidemiology and outcomes statistics an updated 2024 report from Heart Failure Society of America","volume":"31","author":"Bozkurt","year":"2025","journal-title":"J Card Fail"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed tomography","volume":"15","author":"Agatston","year":"1990","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/joim.13176","article-title":"Coronary artery calcium scoring: An evidence-based guide for primary care physicians","volume":"289","author":"Cheong","year":"2021","journal-title":"J. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jcct.2012.02.008","article-title":"Risk stratification of non-contrast CT beyond the coronary calcium scan","volume":"6","author":"Madaj","year":"2012","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.jcmg.2015.12.024","article-title":"Noncoronary measures enhance the predictive value of cardiac CT above traditional risk factors and CAC score in the general population","volume":"9","author":"Mahabadi","year":"2016","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bernardini, F., Gelfusa, M., Celeski, M., Coletti, F., Nusca, A., De Stefano, D., Piccirillo, F., Mangiacapra, F., Gallo, P., and Cammalleria, V. (2022). Beyond the calcium score: What additional information from a CT scan can assist in cardiovascular risk assessment?. Appl. Sci., 13.","DOI":"10.3390\/app13010241"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/0002-8703(93)90536-I","article-title":"Evaluation of left ventricular mass: Comparison of ultrafast computed tomography, magnetic resonance imaging, and contrast left ventriculography","volume":"126","author":"Yamaoka","year":"1993","journal-title":"Am. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/0002-8703(94)90678-5","article-title":"Total biventricular volume and total left ventricular volume by ultrafast computed tomography: Prediction of left ventricular mass","volume":"127","author":"Bleiweis","year":"1994","journal-title":"Am. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1023\/A:1026523924838","article-title":"A simple single slice method for measurement of left and right ventricular enlargement by electron beam tomography","volume":"16","author":"Mao","year":"2000","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/RCT.0b013e318159a49e","article-title":"Comparison of methods to measure heart size using noncontrast-enhanced computed tomography: Correlation with left ventricular mass","volume":"32","author":"Daniel","year":"2008","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.amjcard.2012.12.044","article-title":"Usefulness of biventricular volume as a predictor of mortality in patients with diabetes mellitus (from the Diabetes Heart Study)","volume":"111","author":"Cox","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13098-015-0055-y","article-title":"Predictors of all-cause and cardiovascular disease mortality in type 2 diabetes: Diabetes Heart Study","volume":"7","author":"Raffield","year":"2015","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"188","DOI":"10.23907\/2011.024","article-title":"When is Having a Big Heart a Problem?","volume":"1","author":"Fishbein","year":"2011","journal-title":"Acad. Forensic Pathol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1161\/CIRCIMAGING.113.000690","article-title":"Size matters! Impact of age, sex, height, and weight on the normal heart size","volume":"6","author":"Pfaffenberger","year":"2013","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e223","DOI":"10.1016\/j.jacc.2022.08.004","article-title":"2022 ACC\/AHA Guideline for the diagnosis and management of aortic disease: A report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"80","author":"Isselbacher","year":"2022","journal-title":"J Am Coll Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJM198710223171717","article-title":"Simplified calculation of body-surface area","volume":"317","author":"Mosteller","year":"1987","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sosnowski, M., Parma, Z., Syzd\u00f3\u0142, M., Bro\u017cek, G., Harpula, J., Tendera, M., and Wojakowski, W. (2025). A Novel Concept of the \u201cStandard Human\u201d in the Assessment of Individual Total Heart Size: Lessons from Non-Contrast-Enhanced Cardiac CT Examinations. Diagnostics, 15.","DOI":"10.3390\/diagnostics15121502"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"ehae666.2889","DOI":"10.1093\/eurheartj\/ehae666.2889","article-title":"Left atrial volume in obesity and hypertension: An innovative \u201cideal human\u201d index allows for weighing their impact\u2014A non-contrast cardiac CT study","volume":"45","author":"Sosnowski","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Everitt, B.S., and Howell, D. (2005). Stanine scores. Encyclopedia of Statistics in Behavioral Science, John Wiley. Ltd.","DOI":"10.1002\/0470013192"},{"key":"ref_36","first-page":"23","article-title":"The female-male gap in life expectancy in Poland","volume":"1","year":"2011","journal-title":"Stud. Demogr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA J. Am. Med. Assoc., 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1093\/ehjci\/jev337","article-title":"Normal values of left ventricular mass and cardiac chamber volumes assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study","volume":"17","author":"Fuchs","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jcct.2017.01.011","article-title":"Mid-diastolic left ventricular volume and mass: Normal values for coronary computed tomography angiography","volume":"11","author":"Juneau","year":"2017","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jcct.2019.11.003","article-title":"Reference values for mid-diastolic right ventricular volume in a population referred for cardiac computed tomography: An additional diagnostic value to cardiac computed tomography","volume":"14","author":"Massalha","year":"2020","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/j.jcct.2020.06.016","article-title":"Association between body mass index (BMI) and cardiac chamber size as measured by a novel artificial intelligence (AI) system on cardiac computed tomography angiography (CCTA) images","volume":"14","author":"Shanbhag","year":"2020","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1089\/whr.2020.0052","article-title":"Cardiac gated computed tomography angiography discloses a correlation between the volumes of all four cardiac chambers and heart rate in men but not in women","volume":"1","author":"Shalmon","year":"2020","journal-title":"Women\u2019s Health Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.jcct.2023.08.001","article-title":"AI-based, automated chamber volumetry from gated, non-contrast CT","volume":"17","author":"Jacob","year":"2023","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jcct.2024.04.006","article-title":"AI-enabled cardiac chambers volumetry in coronary artery calcium scans (AI-CACTM) predicts heart failure and outperforms NT-proBNP: The multi-ethnic study of Atherosclerosis","volume":"18","author":"Naghavi","year":"2024","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.0954-6820.1951.tb13194.x","article-title":"The Normal Size of the Heart Muscle Weight","volume":"139","author":"Friedman","year":"1951","journal-title":"Acta Med. Scand."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.forsciint.2015.04.036","article-title":"Postmortem heart weight modelled using piecewise linear regression in 27,645 medicolegal autopsy cases","volume":"252","author":"Wingren","year":"2015","journal-title":"Forensic Sci. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.chest.2019.08.2185","article-title":"Estimated ventricular size, asthma severity, and exacerbations: The Severe Asthma Research Program III cohort","volume":"157","author":"Ash","year":"2020","journal-title":"Chest"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_49","first-page":"78","article-title":"The Standard Human Index: A Proposal for the Unification of Biometric Data","volume":"4","author":"Sosnowski","year":"2026","journal-title":"IgMin Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2350\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:14:28Z","timestamp":1773922468000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062350"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062350","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]}}}