Sex and race differences in right ventricular structure and function: The multi-ethnic study of atherosclerosis-right ventricle study

Steven M. Kawut, João A.C. Lima, R. Graham Barr, Harjit Chahal, Aditya Jain, Harikrishna Tandri, Amy Praestgaard, Emilia Bagiella, Jorge R. Kizer, W. Craig Johnson, Richard A. Kronmal, David A. Bluemke

Research output: Contribution to journalArticle

164 Scopus citations


Background: Right ventricular (RV) morphology is an important predictor of outcomes in heart and lung disease; however, determinants of RV anatomy have not been well studied. We examined the demographic factors associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease. Methods and results: In the Multi-Ethnic Study of Atherosclerosis (MESA), cardiac magnetic resonance imaging was performed on 5098 participants. Right ventricular volumes and mass were available for 4204 participants. Normative equations for RV parameters were derived with an allometric approach. The study sample (n=4123) was 61.5±10.1 years of age and 47.5% men. Older age was associated with lower RV mass (<5% lower mass per decade), with larger age-related decrements in men than in women (P<0.05 for interaction). Older age was also associated with higher RV ejection fraction, an association that differed between races/ethnicities (P≤0.01 for interaction). Overall, men had greater RV mass (<8%) and larger RV volumes than women, but had lower RV ejection fraction (4% in absolute terms; P<0.001). Blacks had lower RV mass than whites (P≤0.002), whereas Hispanics had higher RV mass (P≤0.02). When the derived normative equations were used, 7.3% (95% confidence interval, 6.5 to 8.1) met the criteria for RV hypertrophy, and 5.9% (95% confidence interval, 5.2 to 6.6) had RV dysfunction. Conclusion: Age, sex, and race are associated with significant differences in RV mass, RV volumes, and RV ejection fraction, potentially explaining distinct responses of the RV to cardiopulmonary disease.

Original languageEnglish (US)
Pages (from-to)2542-2551
Number of pages10
Issue number22
StatePublished - Jun 7 2011



  • heart ventricles
  • hypertension
  • magnetic resonance imaging
  • pulmonary
  • pulmonary heart disease
  • sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Kawut, S. M., Lima, J. A. C., Barr, R. G., Chahal, H., Jain, A., Tandri, H., Praestgaard, A., Bagiella, E., Kizer, J. R., Johnson, W. C., Kronmal, R. A., & Bluemke, D. A. (2011). Sex and race differences in right ventricular structure and function: The multi-ethnic study of atherosclerosis-right ventricle study. Circulation, 123(22), 2542-2551.