This study was designed to quantitate the influence of 20 clinical, hemodynamic, and volume determinants of left ventricular (LV) structure. Systemic hemodynamics, intravascular volume, and LV echocardiographic measurements were collected in a heterogeneous population of 171 patients. Stepwise multiple-regression analysis indicated that body weight and body-surface area were the most powerful determinants of LV chamber size, wall thickness, and muscle mass. Age, a pressure independent determinant of myocardial mass, had no influence on chamber size or LV function. Arterial pressure correlated best with the relative wall thickness and chamber volume. Intravascular volume was a major discriminator for chamber volume, LV mass, and velocity of circumferential fiber shortening. It is concluded that body weight, arterial pressure, intravascular volume, and age are each independent determinants of the LV dimension. Systolic pressure most closely correlated with relative wall thickness and thereby is the best predictor of degree of concentric LV hypertrophy.