Lv Mass Index - Devereux LV Mass, LVMI, and RWT

The LV mass index is an echocardiography measurement that divides the left ventricular mass by the patient's body surface area so the result can be compared against sex-specific reference ranges. The LV mass index calculator applies the Devereux linear formula to LVEDD, IVSd, and PWd, then indexes the LV mass to body surface area using the Mosteller equation, and pairs the result with relative wall thickness to label the hypertrophy pattern.

• • Grading suspected LV hypertrophy: place a routine echo report into the ASE normal, mild, moderate, or severe band once LVEDD, IVSd, PWd, height, and weight are entered.
• • Picking the geometry pattern: use the relative wall thickness row to distinguish concentric remodeling from concentric or eccentric hypertrophy when LVMI is above the cutoff.
• • Tracking LVMI across visits: re-enter follow-up echo measurements and compare the LVMI category and geometry pattern against an earlier reading to see if mass is changing.

The Devereux linear method is one of three ways the ASE chamber quantification recommendations describe for measuring left ventricular mass, used when image quality is enough to draw clean linear dimensions but not enough for a 2D or 3D disk summation.

A single LV mass in grams is hard to interpret without the patient's size. The calculator is an educational and reference tool, not a substitute for the interpreting physician's report.

For a cardiovascular screening tool that pairs with the LVMI read in a vascular workup, the Ankle-Brachial Index Calculator turns systolic blood pressure ratios into a peripheral artery disease risk score.

The LV mass index calculator estimates LV mass from the three echo measurements with the Devereux cube formula, indexes the result to body surface area from height and weight with the Mosteller equation, and combines LVMI with relative wall thickness to label the geometry pattern.

• sex: female or male; picks the ASE LVMI upper cutoffs of 95 and 115 g/m^2, then 108 and 131 g/m^2, and 121 and 148 g/m^2.
• weight: body weight in kilograms; enters the Mosteller BSA formula together with height.
• height: body height in centimeters; enters the Mosteller BSA formula together with weight.
• LVEDD: left ventricular end-diastolic dimension on parasternal long-axis echo, in centimeters; raised to the third power by the Devereux formula.
• IVSd: interventricular septal end-diastolic wall thickness, in centimeters; added to LVEDD and PWd before cubing.
• PWd: posterior wall end-diastolic thickness, in centimeters; added to LVEDD and IVSd before cubing.

The Devereux formula treats the left ventricle as a thick-walled prolate shell. The 0.8 and 0.6 constants are the empirical correction published when the equation was validated against necropsy mass, and 1.04 g/cm^3 is the assumed density of heart muscle.

The calculator applies a fixed 0.42 RWT cutoff and combines it with the LVMI band to produce the geometry label, so a high LVMI with a high RWT reads as concentric hypertrophy and a high LVMI with a low RWT reads as eccentric hypertrophy.

According to Devereux RB et al., JACC 1986, left ventricular mass in grams is 0.8 x {1.04 x [(LVEDD + IVSd + PWd)^3 - LVEDD^3]} + 0.6.

When a separate Mosteller BSA is needed for another index, the Body Surface Area Calculator computes the same square-root formula from height and weight in a single step.

Four concepts drive the result.

The Devereux method, the Mosteller index, and the 0.42 RWT cutoff each come from a different publication, but the calculator combines them so the result can be read with the same four-quadrant geometry diagram the ASE uses.

Applying a single 115 g/m^2 threshold to both sexes would over-diagnose hypertrophy in men and under-diagnose it in women, which is why the calculator asks for biological sex first.

For another echocardiography index that uses body surface area to grade severity, the Aortic Valve Area Calculator turns a continuity-equation result into a valve area in cm^2 indexed to BSA.

The form takes six inputs and returns LV mass, LVMI, RWT, and the geometry pattern.

1. 1 Choose the sex used for the cutoffs: select Female or Male at the top of the form so the LVMI band matches the published sex-specific reference range.
2. 2 Enter weight in kilograms and height in centimeters: use the patient's current weight and height; the Mosteller BSA runs on these two numbers and feeds the LVMI denominator.
3. 3 Enter LVEDD from the echo report: type the left ventricular end-diastolic dimension in centimeters, usually between 3.9 and 5.6 cm in a healthy adult.
4. 4 Enter IVSd and PWd in centimeters: type the interventricular septal and posterior wall end-diastolic thicknesses, typically 0.6 to 1.1 cm in a healthy adult.
5. 5 Read the LVMI, RWT, and category rows: look at the LVMI value with the LVMI Category label first, then check RWT and the Geometry Pattern for the four-quadrant read.
6. 6 Compare the geometry against the cutoffs: use the 0.42 RWT row to decide between concentric remodeling, concentric hypertrophy, eccentric hypertrophy, or normal geometry.

A sonographer finishing a parasternal long-axis loop on a 65 kg, 165 cm adult woman enters LVEDD 4.7 cm, IVSd 0.9 cm, and PWd 0.9 cm. The calculator returns LVMI 82.7 g/m^2 with Normal range and Normal geometry, which matches a quick visual read. If a second study returns IVSd 1.1 cm and PWd 1.0 cm, the LVMI moves into the moderate band and the geometry label changes.

When body composition matters for how the echo numbers are read, the Lean Body Mass Calculator estimates lean mass from a few anthropometric inputs and can be used alongside the LVMI result.

Indexing LV mass to body surface area is useful for several clinical and teaching workflows.

• • Sex-specific LVMI bands: the category label is taken from the ASE chamber quantification recommendations, so the calculator does not apply a single threshold to both sexes.
• • Visible Devereux formula: the cube formula and the 0.8 plus 0.6 corrections are shown in the page, so a reader can match the calculator's number to a hand calculation.
• • Mosteller BSA in the same form: height and weight are entered once and the Mosteller BSA is computed in line, so the LVMI denominator is consistent with the ASE recommendations.
• • Geometry pattern beside the LVMI: relative wall thickness is computed and the 0.42 cutoff is applied, so the geometry label matches the four-quadrant diagram the ASE recommends.
• • Real-time recalculation: the result panel updates as each input is typed, which makes it easy to see how a small change in IVSd or PWd moves the LVMI band.

The same form works for the common adult echo and for repeat studies, so a follow-up reading can be entered the same way as the baseline.

For a body-size index that does not require echo measurements, the BMI Calculator takes the same height and weight inputs and returns a different denominator that is easier to communicate to patients.

The result depends on the three echo measurements and the body surface area.

• • The Devereux linear method is less accurate in heavily dilated ventricles or in ventricles with focal wall abnormalities, where the ASE recommends 2D or 3D disk summation instead.
• • The calculator applies the Devereux linear equation and the Mosteller BSA only, and does not adjust for indexing to height in meters to the 2.7 power, which is an alternative in pediatric and obesity work.
• • The result is an educational estimate and should not be used to override the reading cardiologist's report, which has access to the full echo and the patient's clinical context.

The 0.42 RWT cutoff is fixed in the calculator because that is the value the ASE chamber quantification document uses to define concentric geometry, but the same echo can be reread with a different cutoff in research or pediatric settings.

According to EACVI expert consensus (Galderisi et al., EHJ Cardiovasc Imaging 2017), the linear method is acceptable when image quality prevents the 2D or 3D disk summation, and the sex-specific LVMI normal range is 43-95 g/m^2 for women and 49-115 g/m^2 for men.

According to Mosteller RD, NEJM 1987, body surface area in square meters equals the square root of height in centimeters times weight in kilograms divided by 3600.

When obesity or low body weight affects how the LVMI is read, the Ideal Body Weight Calculator provides a reference weight that can be compared against the patient's actual weight before re-checking the LVMI band.