Contrast-enhanced cardiac CT angiography establishes age- and sex-specific reference values for maximal systolic left atrial volume and ventricular dimensions

This single-centre retrospective study investigated whether contrast-enhanced cardiac CT angiography (CCTA) can be used to define normal reference intervals for maximal systolic left atrial volume (LAVmax) and cardiac chamber dimensions. A total of 250 asymptomatic individuals without cardiac disease were included to generate age-, sex-, and body surface area (BSA)-adjusted normative data. LAVmax was quantified using both a 3D volumetric method and a traditional 2D area–length technique, while a semi-automated 3D tool was applied to measure ventricular and atrial volumes. The study showed that LAVmax increases progressively with age in both men and women; however, when indexed to BSA, sex-related differences largely disappeared. The 3D approach provided greater absolute values and demonstrated better reproducibility (r = 0.86, P < 0.001) compared with the area–length method. Age and sex also influenced right ventricular end-diastolic volume and left ventricular ejection fraction. Overall, the study provides robust, CCTA-based normal ranges for atrial and ventricular volumes across age and sex groups. These findings support an expanded role for CCTA in functional and structural assessment beyond its conventional use in coronary imaging.