Body surface area (BSA) is often used in cardiac MRI quantification to index cardiac volumes and mass. The normal range for BSA in adults varies, but it is typically between 1.5 to 2.2 square meters. BSA is calculated using a mathematical formula based on an individual’s weight and height. It’s important to note that BSA can vary significantly depending on factors such as sex, age, and overall body composition. None of the provided references directly address the normal range for BSA in adults.
Studies have shown that indexing cardiac parameters to BSA may lead to underestimation of left ventricular (LV) hypertrophy in overweight individuals.[1-2] This is because BSA indexation can normalize LV mass (LVM) in overweight individuals, potentially masking hypertrophy. Similarly, BSA-indexation can overly decrease volumes in overweight individuals compared to normal-weight individuals.
Alternative methods of indexing, such as using height or ideal body surface area (iBSA), have been proposed to better predict outcomes in overweight and obese populations. For instance, indexing left atrial volumes to height, height-squared, or iBSA has been shown to better predict mortality and cardiovascular events across a range of body sizes, including in overweight and obese individuals.
In conclusion, while BSA is commonly used in cardiac MRI quantification, its relevance and accuracy may be limited, particularly in overweight and obese populations. Alternative methods of indexing, such as using height or iBSA, may provide more accurate and predictive measurements in these populations.
Riffel JH, Schmucker K, Andre F, et al.
Clinical Research in Cardiology : Official Journal of the German Cardiac Society. 2019;108(4):411-429. doi:10.1007/s00392-018-1371-7.
Snel GJH, Slart RHJA, Velthuis BK, et al.
PloS One. 2022;17(12):e0278308. doi:10.1371/journal.pone.0278308.
Davis EF, Crousillat DR, He W, et al.
JACC. Cardiovascular Imaging. 2022;15(6):989-997. doi:10.1016/j.jcmg.2022.02.006.