Analysis of the cardiac chambers for all CMR examinations was performed manually across two core laboratories according to pre-approved standard operating procedures using cvi42 post-processing software (Version 5.1.1, Circle Cardiovascular Imaging Inc., Calgary, Canada) by observers blinded to all exposures. LV papillary muscles were included in blood pool volumes and excluded from LV mass. Detailed descriptions of analysis methodology, including reference ranges, exemplar contours and intra- and inter-observer variability, have been previously described . The CMR parameters examined in this study were left ventricular end-diastolic volume, end-systolic volume, stroke volume, ejection fraction and mass and left atrial maximal volume.