Left Ventricular Mass Index Calculator
Left Ventricular Mass Index Calculator
Devereux’s formula for left ventricular mass from three linear echo measurements, indexed to body surface area and read against the ASE and EACVI limits — with the relative wall thickness that decides which geometry it is.
LV mass index, Devereux formula
Devereux, indexed to BSAMale; LVIDd 5.0 cm, septum 1.1 cm, posterior wall 1.0 cm, BSA 1.9 m²
Formula
LV mass index (g/m²) = LV mass / body surface area
Relative wall thickness = (2 × PWTd) / LVIDd
All dimensions in cm, at end-diastole
- the cube, and why precision matters
- the bracket is the volume of myocardium: the cube of the whole end-diastolic outer dimension minus the cube of the cavity. Because it is a cube, errors amplify — a 2 mm overestimate of one wall thickness adds about 26 g at the dimensions of the worked example, and about 20 g at a smaller ventricle
- 1.04, 0.8 and 0.6
- 1.04 is the specific gravity of myocardium in g/mL, converting the volume into a mass. The 0.8 and 0.6 are the correction Devereux derived against necropsy mass in 1986, because the uncorrected cube formula over-estimated. They are not a unit conversion and cannot be dropped
- indexed to body surface area
- the convention the ASE and EACVI limits were set with. Indexing to height to the power 2.7 detects more hypertrophy in obesity, with different limits that do not transfer to the figures in the table below
- relative wall thickness, and what the method cannot do
- twice the posterior wall over the cavity diameter, cut-off 0.42, separating concentric from eccentric geometry at any given mass — concentric carries the worse prognosis and points at a pressure load. The method assumes a symmetrically thickened ellipsoid, so asymmetric septal hypertrophy, regional thickening and infiltrative disease need two- or three-dimensional mass instead
Worked example
Male; LVIDd 5.0 cm, septum 1.1 cm, posterior wall 1.0 cm, BSA 1.9 m²
Outer dimension = 5.0 + 1.1 + 1.0 = 7.1 cm, and 7.1³ − 5.0³ = 357.911 − 125.000 = 232.911 cm³
× 1.04 = 242.227, × 0.8 = 193.782, + 0.6 = 194 g
Indexed: 194.38 / 1.9 = 102 g/m², within the male reference range of up to 115 g/m²
The same 102 g/m² in a woman is mildly increased, because the female upper limit is 95 g/m². One number, two verdicts, and only the reference limit changed
Relative wall thickness = 2 × 1.0 / 5.0 = 0.40, at or below the 0.42 cut-off, so normal geometry rather than concentric remodelling
Add 2 mm to the septum alone: the mass becomes 220 g and the index 116 g/m² — a 14 g/m² move from one 2 mm measurement, and now past the 115 g/m² male limit. That is what cubing a dimension does to measurement error
ASE and EACVI reference limits for LV mass index, and for the geometry
| Category | Men (g/m²) | Women (g/m²) | Relative wall thickness |
|---|---|---|---|
| Normal | 49 to 115 | 43 to 95 | 0.42 or below is normal geometry; above 0.42 is concentric remodelling |
| Mildly increased | 116 to 131 | 96 to 108 | 0.42 or below is eccentric hypertrophy; above 0.42 is concentric hypertrophy |
| Moderately increased | 132 to 148 | 109 to 121 | Same division applies |
| Severely increased | 149 or more | 122 or more | Same division applies |
What a 2 mm measurement error does, at one set of dimensions
| Change from the worked example | LV mass (g) | Index (g/m²) | Shift in index |
|---|---|---|---|
| None: LVIDd 5.0, septum 1.1, posterior wall 1.0 | 194 | 102 | — |
| Septum 2 mm thicker (1.3 cm) | 220 | 116 | +14 |
| Cavity 2 mm larger (5.2 cm) | 207 | 109 | +7 |
| Both walls 2 mm thicker | 248 | 130 | +28 |
A cube, two constants, and a denominator that misbehaves
Devereux’s formula turns three linear echocardiographic measurements into a mass. The cavity diameter and the two wall thicknesses at end-diastole give an outer dimension; cubing it and subtracting the cube of the cavity gives the volume of myocardium; multiplying by 1.04, the specific gravity of muscle, gives a mass. The 0.8 and the 0.6 are not unit conversions. They are the regression Devereux derived against necropsy mass in 1986, because the uncorrected cube formula over-estimated, and the formula is wrong without them.
The cube is the first thing to understand about using it. A 2 mm change in one wall thickness — well inside the reproducibility of a linear measurement — moves the mass by about 26 g and the indexed value by about 14 g/m², more than enough to cross a reference limit. So a value near a limit should be repeated, measured in the same frame and at the same level, rather than reported. The cavity diameter deserves particular care because it appears twice and with opposite signs: it is inside the outer dimension that gets cubed, and it is the cube that gets subtracted.
The denominator misbehaves in a predictable way. Indexing to body surface area is the convention the ASE and EACVI reference limits were built on, and it works because mass scales with body size. In obesity it works against you: body surface area grows with adiposity as well as frame, so the denominator inflates and real hypertrophy is normalised away. The guideline notes that indexing to height raised to the power 2.7 identifies more hypertrophy in the obese — but the limits are different, and a height-indexed value cannot be read against the 115 and 95 g/m² figures on this page.
Mass is only half of the reading. Relative wall thickness — twice the posterior wall divided by the cavity, with 0.42 as the cut-off — says how the muscle is arranged, and the ASE and EACVI classification needs both: normal geometry, concentric remodelling, concentric hypertrophy, eccentric hypertrophy. Concentric geometry is the response to a pressure load and carries the worse prognosis at the same mass. The whole method assumes a symmetrically thickened ellipsoid, so in asymmetric septal hypertrophy, regional thickening after infarction and infiltrative disease the linear formula should give way to two- or three-dimensional mass. This supports a clinician’s judgement rather than replacing it.
Frequently asked questions
What is the Devereux formula for left ventricular mass?
LV mass in grams = 0.8 × {1.04 × [(LVIDd + IVSd + PWTd)³ − LVIDd³]} + 0.6, all dimensions in centimetres at end-diastole. The 1.04 is the specific gravity of myocardium; the 0.8 and 0.6 are Devereux’s 1986 correction against necropsy mass.
What is a normal left ventricular mass index?
The 2015 ASE and EACVI recommendations give up to 115 g/m² in men and 95 g/m² in women for the linear method, then 116 to 131 and 96 to 108 mildly increased, 132 to 148 and 109 to 121 moderately increased, and 149 or more and 122 or more severely increased.
Why index LV mass to body surface area?
Because mass scales with body size and the reference limits were set on BSA-indexed values. The known failure is obesity: BSA grows with adiposity as well as frame, so indexing to it under-detects hypertrophy. The guideline notes that height to the power 2.7 identifies more, with its own limits.
What does relative wall thickness add?
It separates concentric from eccentric geometry at any given mass: twice the posterior wall thickness over the cavity diameter, cut-off 0.42. Concentric geometry is the characteristic response to a pressure load and carries the worse prognosis at the same mass.
How accurate is the linear method?
It assumes a symmetrically thickened ellipsoid and cubes one outer dimension, so error amplifies — a 2 mm change in one wall moves the mass by roughly 26 g — and asymmetric hypertrophy is over-estimated. In asymmetric septal hypertrophy, regional thickening or infiltrative disease, use two- or three-dimensional mass.
Related calculators
References
- Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57(6):450–458.
- Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.
- Comparison of electrocardiographic criteria for left ventricular hypertrophy against echocardiographic myocardial mass index in 95 patients. Acta Medica Lituanica. 2022. Accessed via journals.vu.lt, October 2026.
Not medical advice. For healthcare professionals and education. Reference intervals vary by laboratory and assay — always use your own laboratory's. Never base a dose or a treatment decision on this page alone. Full disclaimer at calcengines.com/disclaimer/