Normal Range for CTLVIDD in Women
The normal range for corrected left ventricular internal diameter in diastole (CTLVIDD) in adult women is ≤40 mm/m² when indexed to body surface area. 1
Standard Linear Measurement Values
The absolute left ventricular internal diameter in diastole (LVIDD) for women typically ranges from 3.9 to 5.3 cm, with an upper limit of normal at approximately 5.3 cm. 1 However, indexing to body surface area provides more accurate assessment across different body sizes.
Body Surface Area Indexing
- Upper limit of normal LVIDD indexed to BSA: 40.8 mm/m² in women 1
- Alternative upper limit cited: 35 mm/m² in female athletes (though this represents a more conservative athletic population threshold) 1
- The indexed measurement accounts for variations in body size and is the preferred method for clinical assessment 1
Clinical Context and Interpretation
Comparison with Male Values
Women have smaller absolute LV dimensions compared to men, with the upper limit of LVIDD being approximately 5.3 cm in women versus 5.9 cm in men. 1 When indexed to BSA, the upper limit remains higher in women (40.8 mm/m²) compared to men (35.3 mm/m²), reflecting physiologic differences in body composition. 1
Athletic Populations
In elite female athletes, LVIDD can reach up to 66 mm (mean 49 mm), with approximately 14% showing substantial enlargement beyond 60 mm while maintaining normal systolic function. 1, 2 The upper limit for female athletes when indexed to BSA is reported as 40 mm/m². 1
Measurement Technique Considerations
Linear measurements should be obtained using the inner-edge-to-inner-edge method from the parasternal long-axis view at end-diastole. 1 The measurement is taken from the interventricular septum to the posterior wall, perpendicular to the long axis of the ventricle.
Important Caveats
- LVIDD measurements may underestimate true LV size in patients with regional wall motion abnormalities or asymmetric remodeling 1, 3
- In one study, 54% of patients with severely dilated LV volumes by volumetric assessment had normal LVIDD measurements, highlighting the limitations of linear measurements 3
- Volumetric assessment using Simpson's biplane method is superior to linear measurements, particularly when LV geometry is abnormal 1, 3
Clinical Thresholds for Abnormality
According to ASE/EACVI guidelines, LVIDD in women is classified as: 1
- Normal: 3.9-5.3 cm (or ≤40.8 mm/m² indexed)
- Mildly abnormal: 5.4-5.7 cm
- Moderately abnormal: 5.8-6.1 cm
- Severely abnormal: ≥6.2 cm
Special Populations Requiring Adjustment
In patients with hypertension and heart failure with preserved ejection fraction, indexed LVIDD may appear normal (mean 2.6 cm/m²) despite elevated filling pressures, as the ventricle undergoes concentric remodeling rather than eccentric dilatation. 4 This underscores the importance of assessing relative wall thickness and LV mass in addition to cavity size.