Abstract
Statistical models of cardiac anatomy and motion often pool data across sexes, yet it remains unclear how biological sex differences are repre-sented in these models. When applied to pooled cohorts, linear principal compo-nent analysis may capture between-sex variation as dominant modes, potentially complicating the interpretation of anatomical and functional variability. Here, we investigate how sex differences are represented in biventricular models derived from cine cardiovascular magnetic resonance imaging. Time-resolved biventricular meshes were reconstructed from 372 asymptomatic adults. Principal component analysis was applied separately to end-diastolic mesh coordinates, representing anatomy, and to full-cycle end-diastolic-refer-enced Lagrangian displacement fields, representing function. Pooled and sex-specific PCA spaces were compared using variance partitioning, mode align-ment, and bootstrap stability analysis. Four anatomical modes satisfied bootstrap stability criteria. The leading pooled anatomical mode explained 31% of total shape variance and was dominated by between-sex differences, which accounted for 57% of that mode’s variance. In contrast, five stable functional modes explained 67% of displacement variance and remained closely aligned between pooled and sex-specific decompositions. These findings show that sex-related differences are represented differently in anatomical and functional PCA models: between-sex variation dominated the leading anatomical mode, whereas dominant functional displacement modes re-mained closely aligned between sexes. This suggests that, despite large sex-spe-cific anatomical differences, the principal functional patterns captured by the model are largely preserved between sexes in asymptomatic adults.
Links to Paper and Supplementary Materials
Main Paper (Open Access Version): https://papers.miccai.org/miccai-2026-sat/paper/DT4H_032.pdf
SharedIt Link: Not yet available
SpringerLink (DOI): Not yet available
Supplementary Material: Not Submitted
Link to Open Review
Open Review Page: https://openreview.net/forum?id=HL0eCdyr7D
BibTex
@InProceedings{BuoSte_Sexspecific_MICCAISAT2026,
author = { Buoso, Stefano AND Visser, Valery L. AND Leuders, Pia AND Fuetterer, Maximilian AND Spengler, Christina AND Kozerke, Sebastian},
title = { { Sex-specific signatures in cardiac anatomy and function in CMR-Derived Biventricular Digital-Twins } },
booktitle = {Medical Image Computing and Computer Assisted Intervention -- MICCAI 2026 Workshops and Challenges},
year = {2026},
publisher = {Springer Nature Switzerland},
volume = {LNCS 17275},
month = {pending},
page = {pending}
}