Heart shape captures variation in cardiac structure beyond traditional phenotypes of mass and volume. Although observational studies have demonstrated associations with cardiometabolic risk factors and diseases, its genetic basis has not been investigated. We utilised cardiovascular magnetic resonance images from 38,858 UK Biobank participants to construct a heart shape atlas from bi-ventricular end-diastolic and end-systolic surface mesh models through principal component (PC) analysis.

Genome-wide association studies were performed on the first 14 PCs that captured 83.3% of shape variance. We identified the first 14 PCs with estimated biological features below:

PC% Shape variance capturedEstimated biological feature
134.1Overall heart size
210.6Mitral and tricuspid annular plane systolic excursion
37.8Ventricular sphericalisation
45.5LV basal position
55.5Lateral-septal width
64.2LV length
74.0LV apical position
82.4Tricuspid valve opening size
92.1Systolic basal excursion
102.0RV sphericity
111.6Rounder ventricular apex
121.3Relative LV size
131.1Ejection fraction
141.0LV size and reduced ejection fraction
Biological feature explanations from the first 14 principal components of the ED-ES RVLV shape models.

PCA Mode 1 showing variations in the overall heart size

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PCA Mode 2 showing variations in mitral and tricuspid annular plane systolic excursion.

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PCA Mode 3 showing variations in ventricular sphericalisation.

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PCA Mode 4 showing variations in LV basal position.

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PCA Mode 5 showing variations in lateral-septal width.

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PCA Mode 6 showing variations in the LV length.

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PCA Mode 7 showing variations in the LV apical position.

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PCA Mode 8 showing variations in the tricuspid valve opening size.

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PCA Mode 9 showing variations in the systolic basal excursion.

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PCA Mode 10 showing variations in the RV sphericity.

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PCA Mode 11 showing variations in the rounder ventricular apex.

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PCA Mode 12 showing variations in the relative LV size.

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PCA Mode 13 showing variations in the ejection fraction.

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PCA Mode 14 showing variations in the LV size and reduced ejection fraction.

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Posterior View