The effects of body mass index on surface electrocardiograms in young adults

Nasir, Javed M.; Rubal, Bernard J.; Jones, Samuel O.

doi:10.1016/j.jelectrocard.2012.07.022

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…As shown, P wave area yielded the highest correlation with LA size (r = 0.42, p<0.001), although heteroscedasticity was present for this correlation (p<0.001), as well as for other ECG variables. Moreover, despite larger body size indices (which might be expected to attenuate measures of P wave dimensions)[23]–[24] among patients without LA dilation, P wave area yielded similar magnitude of correlation with both unadjusted (r = 0.41, p<0.001) and body surface area indexed (r = 0.42, p<0.001) left atrial area, with similarly minimal impact of body size adjustment for all other P wave indices. P wave area in lead V1 remained significantly associated with LA area (p<0.001) on CMR in both forced and stepwise linear regression analyses that controlled for P wave area in all other surface ECG leads.…”

Section: Resultsmentioning

confidence: 88%

P Wave Area for Quantitative Electrocardiographic Assessment of Left Atrial Remodeling

et al. 2014

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BackgroundLeft atrial (LA) dilation provides a substrate for mitral regurgitation (MR) and atrial arrhythmias. ECG can screen for LA dilation but standard approaches do not assess LA geometry as a continuum, as does non-invasive imaging. This study tested ECG-quantified P wave area as an index of LA geometry.Methods and Results342 patients with CAD underwent ECG and CMR within 7 (0.1±1.4) days. LA area on CMR correlated best with P wave area in ECG lead V1 (r = 0.42, p<0.001), with lesser correlations for P wave amplitude and duration. P wave area increased stepwise in relation to CMR-evidenced MR severity (p<0.001), with similar results for MR on echocardiography (performed in 86% of patients). Pulmonary arterial (PA) pressure on echo was increased by 50% among patients in the highest (45±14 mmHg) vs. the lowest (31±9 mmHg) P wave area quartile of the population. In multivariate regression, CMR and echo-specific models demonstrated P wave area to be independently associated with LA size after controlling for MR, as well as echo-evidenced PA pressure. Clinical follow-up (mean 2.4±1.9 years) demonstrated ECG and CMR to yield similar results for stratification of arrhythmic risk, with a 2.6-fold increase in risk for atrial fibrillation/flutter among patients in the top P wave area quartile of the population (CI 1.1–5.9, p = 0.02), and a 3.2-fold increase among patients in the top LA area quartile (CI 1.4–7.0, p = 0.005).ConclusionsECG-quantified P wave area provides an index of LA remodeling that parallels CMR-evidenced LA chamber geometry, and provides similar predictive value for stratification of atrial arrhythmic risk.

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Section: Resultsmentioning

confidence: 88%

P Wave Area for Quantitative Electrocardiographic Assessment of Left Atrial Remodeling

et al. 2014

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“…6 The mean BMI of their patients was 27 kg/m 2 and it was speculated that this was potentially because obese patients have smaller R-wave amplitudes related to the subcutaneous fat between the heart and electrode. 6 No one has studied the effect of BMI on S-ICD screening test lead ECG morphology per se, but we found 1 study that looked at the BMI effect on the 12-lead ECG 24 greater BMI led to lower values of R-and T-wave axes, indicating a rightward shift of both. Furthermore, R-wave voltage and T-wave amplitudes appeared to be BMI dependent, although it peaked at a BMI of 18.5 kg/m 2 and diminished with further increases in weight.…”

Section: Predictors Of Eligibility In Brsmentioning

confidence: 81%

Surface Electrocardiogram Screening for Subcutaneous Implantable Cardioverter-Defibrillators in Japanese Patients With and Without Brugada Syndrome

Kawabata

Goya

Sasaki

et al. 2017

Circ J

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Background: Subcutaneous implantable cardioverter-defibrillators (S-ICD) could eliminate lead-associated complications. We assessed the prevalence of S-ICD ineligibility in conventional ICD recipients and compared it in patients with and without Brugada syndrome (BrS). Methods and Results:Consecutive patients with a transvenous ICD without an indication for antibradycardia pacing were assessed. A patient was considered eligible for S-ICD if the ECG satisfied the screening template, both supine and standing, in ≥1 lead. Among 130 patients (103 men, age 57±15 years), a total of 18 (13.8%) patients were ineligible. The BrS group (n=33) had a significantly higher prevalence of S-ICD screening failure as compared with the non-BrS group (P=0.003; 30% vs. 8.2%). In the BrS group, the body mass index (BMI) was significantly lower, and T/QRS amplitude in lead I was significantly higher in those who were ineligible than that in the patients who were eligible. Of the 10 BrS patients failing the screening, 4 became eligible in the right parasternal electrode position. Conclusions:Among current ICD patients, there was a high incidence of patients with BrS who were unsuitable for S-ICD based on the left parasternal screening test. Suitability screening of patients for S-ICDs should be conducted carefully in patients with BrS, particularly if the BMI is low. Right parasternal electrode positioning should also be tested in such BrS patients.

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“…It is well known that QRS duration is an independent predictor of CRT response, especially when differentiating between QRS duration values below and over 150 milliseconds . Moreover, the T‐wave amplitude is known to be smaller in patients with large BMI, possibly simply related to the larger distance of the surface to the heart. Large BMI is known, for not well‐understood reasons, to reduce CRT response .…”

Section: Discussionmentioning

confidence: 99%

T‐Wave Area Predicts Response to Cardiac Resynchronization Therapy in Patients with Left Bundle Branch Block

Engels

Végh

Deursen

et al. 2014

Cardiovasc electrophysiol

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The effects of body mass index on surface electrocardiograms in young adults

Cited by 14 publications

References 18 publications

P Wave Area for Quantitative Electrocardiographic Assessment of Left Atrial Remodeling

P Wave Area for Quantitative Electrocardiographic Assessment of Left Atrial Remodeling

Surface Electrocardiogram Screening for Subcutaneous Implantable Cardioverter-Defibrillators in Japanese Patients With and Without Brugada Syndrome

T‐Wave Area Predicts Response to Cardiac Resynchronization Therapy in Patients with Left Bundle Branch Block

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