Background: Medical imaging plays a central role in diagnosis; treatment planning and monitoring disease progression and understanding the intricate relationship between body somatotypes and cardiac dimensions in healthy populations offers valuable insights for developing personalized health assessments and targeted preventive strategies.

Aim: This study was designed to assess the correlations between anthropometric variables and radiographic cardiac measurements in different body somatotypes.

Materials and methods: This prospective cross-sectional study was conducted in some selected healthcare facilities that have X-rays and Echocardiography machines in Nnewi and Awka, Anambra State, Nigeria. Standard protocols for chest X-rays and echocardiography were adopted for the examinations and data such as demographic variables (age, gender), body mass index (BMI), cardiac dimensions and somatotype of the participants were recorded for analysis.

Results: BMI showed a significant positive correlation with left ventricular posterior wall thickness in systole (LVPWDs), r = .16, p = .02, indicating that higher BMI was associated with increased posterior wall thickness during systole. BMI also demonstrated a significant negative correlation with left ventricular mass index (LVMI), r = −.33, p < .001. In addition, a small but significant positive correlation was observed between BMI and cardiothoracic ratio (CTR), r = .15, p = .03. For interventricular septal thickness in diastole (IVSd) and systole (IVSs), the ICC was 0.001, with 95% confidence intervals (CIs) spanning negative to positive values (−0.134 to 0.136), suggesting no reliable agreement beyond chance. Similar findings were observed for left ventricular internal diameter in diastole (LVIDd; ICC = 0.001, 95% CI [−0.134, 0.136]) and systole (LVIDs; ICC = 0.000, 95% CI [−0.135, 0.136]), as well as left ventricular posterior wall thickness in diastole (LVPWDd; ICC = 0.004, 95% CI [−0.131, 0.139]) and systole (LVPWDs; ICC = 0.003, 95% CI [−0.132, 0.138]).

Conclusion: A small but significant positive correlation was observed between BMI and cardiothoracic ratio (CTR). All other associations with BMI were not statistically significant. Significant positive correlations were found with LVPWDs and left ventricular mass. BSA was also significantly and negatively correlated with LVMI. No significant relationships were observed between BSA and the remaining cardiac measurements.