ICLR 2026 Poster accepted paper at ICLR 2026. Generative models of 3D cardiovascular anatomy can synthesize informative structures for clinical research and medical device evaluation, but face a trade-off between geometric controllability and realism. We propose CardioComposer: a programmable, inference time framework for generating multi-class anatomical label maps from interpretable ellipsoidal primitives. These primitives represent geometric attributes such as the size, shape, and position of discrete substructures. We specifically develop differentiable measurement functions based on voxel-wise geometric moments, enabling loss-based gradient guidance during diffusion model sampling. Code/project link: https://github.com/kkadry/CardioComposer
