LV Calculator - Left Ventricular Mass Index
Enter standard echocardiographic measurements to calculate left ventricular (LV) mass, the LV mass index (LVMI), and relative wall thickness (RWT). The calculator uses the validated ASE cube formula, classifies your LV geometry into one of four patterns (normal, concentric remodeling, concentric hypertrophy, eccentric hypertrophy), and flags when values fall outside published normal ranges. Enter weight and height to calculate body surface area automatically, or type your BSA directly.
Formula
Worked example
A man with LVEDD 4.8 cm, IVSd 0.9 cm, PWd 0.9 cm, BSA 1.87 m²: sum = 6.6 cm; 6.6³ - 4.8³ = 287.5 - 110.6 = 176.9 cm³; LV mass = 0.8 x (1.04 x 176.9) + 0.6 = 147.6 g; LVMI = 147.6 / 1.87 = 78.9 g/m² (normal for men); RWT = 2 x 0.9 / 4.8 = 0.38 (below 0.42) = normal geometry.
What is the LV calculator?
This tool calculates left ventricular (LV) mass and the LV mass index (LVMI) from three standard echocardiographic measurements: LV end-diastolic dimension (LVEDD), interventricular septal thickness at end-diastole (IVSd), and posterior wall thickness at end-diastole (PWd). It then divides the result by body surface area to produce the LVMI, which corrects for differences in body size. The relative wall thickness (RWT) is calculated alongside, and together LVMI and RWT determine which of four LV geometry patterns best describes the heart: normal geometry, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy. Each pattern carries different clinical implications, particularly for cardiovascular risk.
How to use this calculator
Measure LVEDD, IVSd, and PWd from a parasternal long-axis echocardiographic view at end-diastole using leading-edge-to-leading-edge conventions (ASE method). Enter values in centimetres. Then either enter weight and height so the calculator can estimate your body surface area using the Mosteller formula, or enter your BSA directly if it is already known. Select the patient sex, because the LVMI thresholds that define normal from abnormal differ between men and women. All outputs update instantly.
LV geometry patterns and what they mean
Four geometry patterns emerge from the combination of LVMI and RWT. Normal geometry means both LVMI and RWT are within the reference range, consistent with a healthy left ventricle. Concentric remodeling describes a normal mass with an elevated RWT (above 0.42), which often represents an early adaptation to sustained pressure load such as hypertension; it carries intermediate cardiovascular risk. Concentric hypertrophy is elevated LVMI combined with elevated RWT, typically driven by chronic pressure overload such as systemic hypertension or aortic stenosis, and is the pattern most strongly associated with adverse outcomes including heart failure and sudden death. Eccentric hypertrophy is elevated LVMI with normal or low RWT, usually a consequence of volume overload from conditions such as aortic or mitral regurgitation, and is also associated with increased event rates. Studies show individuals with LV hypertrophy face roughly 2-3 times greater risk of cardiac events over 15 years compared with those with normal LV geometry.
The Devereux cube formula and its limitations
The LV mass formula used here is the Devereux modification of the ASE cube formula: LV mass = 0.8 x [1.04 x ((LVEDD + IVSd + PWd)^3 - LVEDD^3)] + 0.6. It assumes an ellipsoidal LV shape and performs best when wall thickness is relatively uniform and measurements are taken carefully by linear M-mode or 2D echocardiography. The formula can overestimate mass in severely asymmetric hypertrophy (for example, hypertrophic cardiomyopathy with asymmetric septal hypertrophy) and underestimate it in heavily remodeled ventricles. For those cases, 3D echocardiography or cardiac MRI provides more accurate mass quantification. Normal reference ranges in this calculator are from the 2015 ASE/EACVI recommendations for cardiac chamber quantification.
LVMI normal ranges and LV hypertrophy severity (ASE/EACVI 2015)
| Category | Women (g/m²) | Men (g/m²) |
|---|---|---|
| Normal | 43-95 | 49-115 |
| Mildly abnormal | 96-108 | 116-131 |
| Moderately abnormal | 109-121 | 132-148 |
| Severely abnormal | >=122 | >=149 |
Values in g/m², indexed to body surface area. LV geometry is further classified by relative wall thickness (RWT): RWT > 0.42 = concentric pattern; RWT <= 0.42 = eccentric or normal pattern.
Frequently asked questions
What is a normal LV mass index?
According to the 2015 ASE/EACVI guidelines, LVMI up to 95 g/m² is considered normal for women and up to 115 g/m² for men. Values above those limits indicate left ventricular hypertrophy (LVH), graded as mild (women 96-108, men 116-131), moderate (women 109-121, men 132-148), or severe (women 122 or above, men 149 or above).
What is relative wall thickness (RWT)?
RWT is calculated as two times the posterior wall thickness divided by the LV end-diastolic dimension: RWT = (2 x PWd) / LVEDD. It describes the ratio of wall thickness to chamber size. A value above 0.42 indicates a concentric pattern (thick walls relative to the cavity), while 0.42 or below indicates an eccentric or normal pattern (normal or thin walls relative to cavity size).
What is the difference between concentric and eccentric hypertrophy?
Both involve elevated LV mass, but they have different shapes. In concentric hypertrophy the walls are thick relative to the cavity (RWT above 0.42), which is the typical response to sustained pressure overload such as hypertension or aortic stenosis. In eccentric hypertrophy the cavity has enlarged while walls remain relatively thinner (RWT at or below 0.42), typically seen with volume overload from valvular regurgitation or chronic anaemia. Both patterns are associated with higher cardiovascular risk than normal geometry.
Which echocardiographic view should I use for these measurements?
Standard measurements are taken from the parasternal long-axis view using M-mode or 2D-guided M-mode at the level of the mitral valve leaflet tips, at end-diastole (onset of the QRS complex). The ASE recommends the leading-edge-to-leading-edge method: LVEDD from the inner edge of the septum to the inner edge of the posterior wall. IVSd and PWd are measured from the outer edges of each wall. Measurements should be the average of at least three cardiac cycles in normal sinus rhythm and five cycles in atrial fibrillation.
Can this calculator be used for children?
No. The LVMI thresholds in this calculator are validated for adults. In children and adolescents, LV mass is indexed to height raised to the power of 2.7 rather than to BSA, and age- and sex-specific reference ranges apply. A dedicated pediatric echocardiographic reference should be used for patients under 18.
Why does body surface area affect the result?
A larger person naturally has a larger heart, so comparing raw LV mass without accounting for body size would falsely classify many tall or heavy people as having LV hypertrophy. Dividing by BSA removes most of this size effect and makes the result comparable across different body builds. The Mosteller formula used here (BSA = square root of (height in cm x weight in kg / 3600)) is widely used and well validated for clinical echocardiography.