{"title":"心电图特征符合体重过轻和肥胖的世界卫生组织分类","authors":"Satoshi Kurisu, Hiroki Ikenaga, Noriaki Watanabe, Tadanao Higaki, Takashi Shimonaga, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara","doi":"10.1016/j.ijcme.2015.10.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>It is clinically important to recognize how the underweight or obese affects electrocardiogram (ECG). We assessed the effects of body mass index (BMI) on QRS axis or R-wave heights.</p></div><div><h3>Methods</h3><p>From daily outpatient electrocardiograms with sinus rhythm, 203 were selected. The patients were classified into four groups: underweight (<<!--> <!-->18.5<!--> <!-->kg/m<sup>2</sup>), normal weight (18.5–24.9<!--> <!-->kg/m<sup>2</sup>), overweight (25–29.9<!--> <!-->kg/m<sup>2</sup>) and obese (≥<!--> <!-->30<!--> <!-->kg/m<sup>2</sup>).</p></div><div><h3>Results</h3><p>With increasing BMI, QRS axis shifted rightward to leftward. There was a significant inverse correlation between BMI and QRS axis (r<!--> <!-->=<!--> <!-->−<!--> <!-->0.60, p<!--> <!--><<!--> <!-->0.001). Multivariate linear regression analysis among age, female, BMI, hypertension, left ventricular internal dimension and left ventricular mass (LVM) revealed that BMI was an independent determinant of QRS axis (β<!--> <!-->=<!--> <!-->−<!--> <!-->0.52, p<!--> <!--><<!--> <!-->0.0001). Although LVM increased with increasing BMI, R-wave heights in leads V4-5 were similar among the underweight, normal weight and overweight. R-wave heights in leads V4-5 were significantly lower paradoxically in the obese than other groups. With increasing BMI, Sokolow–Lyon index corrected by LVM decreased progressively.</p></div><div><h3>Conclusions</h3><p>Our results suggest that the underweight or obese is strongly associated with QRS axis or R-wave heights.</p></div>","PeriodicalId":73333,"journal":{"name":"IJC metabolic & endocrine","volume":"9 ","pages":"Pages 61-65"},"PeriodicalIF":0.0000,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijcme.2015.10.006","citationCount":"12","resultStr":"{\"title\":\"Electrocardiographic characteristics in the underweight and obese in accordance with the World Health Organization classification\",\"authors\":\"Satoshi Kurisu, Hiroki Ikenaga, Noriaki Watanabe, Tadanao Higaki, Takashi Shimonaga, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara\",\"doi\":\"10.1016/j.ijcme.2015.10.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>It is clinically important to recognize how the underweight or obese affects electrocardiogram (ECG). We assessed the effects of body mass index (BMI) on QRS axis or R-wave heights.</p></div><div><h3>Methods</h3><p>From daily outpatient electrocardiograms with sinus rhythm, 203 were selected. The patients were classified into four groups: underweight (<<!--> <!-->18.5<!--> <!-->kg/m<sup>2</sup>), normal weight (18.5–24.9<!--> <!-->kg/m<sup>2</sup>), overweight (25–29.9<!--> <!-->kg/m<sup>2</sup>) and obese (≥<!--> <!-->30<!--> <!-->kg/m<sup>2</sup>).</p></div><div><h3>Results</h3><p>With increasing BMI, QRS axis shifted rightward to leftward. There was a significant inverse correlation between BMI and QRS axis (r<!--> <!-->=<!--> <!-->−<!--> <!-->0.60, p<!--> <!--><<!--> <!-->0.001). Multivariate linear regression analysis among age, female, BMI, hypertension, left ventricular internal dimension and left ventricular mass (LVM) revealed that BMI was an independent determinant of QRS axis (β<!--> <!-->=<!--> <!-->−<!--> <!-->0.52, p<!--> <!--><<!--> <!-->0.0001). Although LVM increased with increasing BMI, R-wave heights in leads V4-5 were similar among the underweight, normal weight and overweight. R-wave heights in leads V4-5 were significantly lower paradoxically in the obese than other groups. With increasing BMI, Sokolow–Lyon index corrected by LVM decreased progressively.</p></div><div><h3>Conclusions</h3><p>Our results suggest that the underweight or obese is strongly associated with QRS axis or R-wave heights.</p></div>\",\"PeriodicalId\":73333,\"journal\":{\"name\":\"IJC metabolic & endocrine\",\"volume\":\"9 \",\"pages\":\"Pages 61-65\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ijcme.2015.10.006\",\"citationCount\":\"12\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJC metabolic & endocrine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S221476241530013X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJC metabolic & endocrine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S221476241530013X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 12
摘要
目的认识体重过轻或肥胖对心电图的影响具有重要的临床意义。我们评估了身体质量指数(BMI)对QRS轴或r波高度的影响。方法从门诊每日有窦性心律的心电图中抽取203例。将患者分为四组:体重过轻(<18.5 kg/m2)，正常体重(18.5 - 24.9 kg/m2)，超重(25-29.9 kg/m2)和肥胖(≥30 kg/m2)。结果随着BMI的增加，QRS轴向右向左移动。BMI与QRS轴呈显著负相关(r = - 0.60, p <0.001)。年龄、女性、BMI、高血压、左室容积和左室质量(LVM)的多元线性回归分析显示，BMI是QRS轴的独立决定因素(β = - 0.52, p <0.0001)。虽然LVM随BMI的增加而增加，但体重过轻、正常和超重的V4-5导联r波高度相似。肥胖者V4-5导联r波高度明显低于其他组。随着BMI的增加，LVM校正的Sokolow-Lyon指数逐渐降低。结论体重过轻或肥胖与QRS轴或r波高度密切相关。
Electrocardiographic characteristics in the underweight and obese in accordance with the World Health Organization classification
Objective
It is clinically important to recognize how the underweight or obese affects electrocardiogram (ECG). We assessed the effects of body mass index (BMI) on QRS axis or R-wave heights.
Methods
From daily outpatient electrocardiograms with sinus rhythm, 203 were selected. The patients were classified into four groups: underweight (< 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2) and obese (≥ 30 kg/m2).
Results
With increasing BMI, QRS axis shifted rightward to leftward. There was a significant inverse correlation between BMI and QRS axis (r = − 0.60, p < 0.001). Multivariate linear regression analysis among age, female, BMI, hypertension, left ventricular internal dimension and left ventricular mass (LVM) revealed that BMI was an independent determinant of QRS axis (β = − 0.52, p < 0.0001). Although LVM increased with increasing BMI, R-wave heights in leads V4-5 were similar among the underweight, normal weight and overweight. R-wave heights in leads V4-5 were significantly lower paradoxically in the obese than other groups. With increasing BMI, Sokolow–Lyon index corrected by LVM decreased progressively.
Conclusions
Our results suggest that the underweight or obese is strongly associated with QRS axis or R-wave heights.
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