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An increased body mass index (BMI) (>25 kg/m2) is associated with a wide range of electrocardiographic changes. However, the association between electrocardiographic changes and BMI in healthy young individuals with a normal BMI (18.5–25 kg/m2) is unknown. The aim of this study was to evaluate the association between BMI and electrocardiographic parameters.
Data from 1,290 volunteers aged 18 to 30 years collected at our centre were analysed. Only subjects considered healthy by a physician after review of collected data with a normal BMI and in sinus rhythm were included in the analysis. Subjects with a normal BMI (18.5–25 kg/m2) were divided into BMI quartiles analysis and a backward multivariate regression analysis with a normal BMI as a continuous variable was performed.
Mean age was 22.7 ± 3.0 years, mean BMI was 22.0, and 73.4% were male. There were significant differences between the BMI quartiles in terms of maximum P-wave duration, P-wave balance, total P-wave area in lead V1, PR-interval duration, and heart axis. In the multivariate model maximum P-wave duration (standardised coefficient (SC) = +0.112, P < 0.001), P-wave balance in lead V1 (SC = +0.072, P < 0.001), heart axis (SC = −0.164, P < 0.001), and Sokolow-Lyon voltage (SC = −0.097, P < 0.001) were independently associated with BMI.
Increased BMI was related with discrete electrocardiographic alterations including an increased P-wave duration, increased P-wave balance, a leftward shift of the heart axis, and decreased Sokolow-Lyon voltage on a standard twelve lead electrocardiogram in healthy young individuals with a normal BMI.
Alpert MA, Omran J, Bostick BP. Effects of Obesity on Cardiovascular Hemodynamics, Cardiac Morphology, and Ventricular Function. Curr Obes Rep. 2016;5(4):424–34. CrossRef
Lavie CJ, Pandey A, Lau DH, Alpert MA, Sanders P. Obesity and Atrial Fibrillation Prevalence, Pathogenesis, and Prognosis: Effects of Weight Loss and Exercise. J Am Coll Cardiol. 2017;70(16):2022–35. CrossRef
Vaidean GD, Manczuk M, Magnani JW. Atrial electrocardiography in obesity and hypertension: Clinical insights from the Polish-Norwegian Study (PONS). Obesity (Silver Spring. MD. 2016;24(12):2608–14.
Babcock MJ, Soliman EZ, Ding J, A Kronmal R, Goff DC Jr. Pericardial fat and atrial conduction abnormalities in the Multiethnic Study of Atherosclerosis (MESA). Obesity. 2011;19(1):179–84. CrossRef
Liu T, Fu Z, Korantzopoulos P, et al. Effect of obesity on p‑wave parameters in a Chinese population. Ann Noninvasive Electrocardiol. 2010;15(3):259–63. CrossRef
Magnani JW, Lopez FL, Soliman EZ, et al. P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study. Obesity. Silver Spring Md). 2012;20(3):666–72. CrossRef
Frank S, Colliver JA, Frank A. The electrocardiogram in obesity: statistical analysis of 1,029 patients. J Am Coll Cardiol. 1986;7(2):295–9. CrossRef
Fraley MA, Birchem JA, Senkottaiyan N, Alpert MA. Obesity and the electrocardiogram. Obes Rev. 2005;6(4):275–81. CrossRef
Graner M, Pentikainen MO, Siren R, et al. Electrocardiographic changes associated with insulin resistance. NMCD. 2014;24(3):315–20. PubMed
Eisenstein I, Edelstein J, Sarma R, Sanmarco M, Selvester RH. The electrocardiogram in obesity. J Electrocardiol. 1982;15(2):115–8. CrossRef
Kurisu S, Ikenaga H, Watanabe N, et al. Electrocardiographic characteristics in the underweight and obese in accordance with the World Health Organization classification. IJC Metabolic. Endocrine. 2015;9:61–5.
Okin PM, Jern S, Devereux RB, Kjeldsen SE, Dahlof B. Effect of obesity on electrocardiographic left ventricular hypertrophy in hypertensive patients: the losartan intervention for endpoint (LIFE) reduction in hypertension study. Hypertension. 2000;35(1 Pt 1):13–8. CrossRef
Lavie CJ, De Schutter A, Parto P, et al. Obesity and Prevalence of Cardiovascular Diseases and Prognosis-The Obesity Paradox Updated. Prog Cardiovasc Dis. 2016;58(5):537–47. CrossRef
Kurisu S, Ikenaga H, Watanabe N, et al. Implications of World Health Organization classification for body mass index on the correlations between common electrocardiographic indexes for left ventricular hypertrophy and left ventricular mass. Clin Exp Hypertens. 2016;38(8):715–20. CrossRef
Garg A, Lehmann MH. Prolonged QT interval diagnosis suppression by a widely used computerized ECG analysis system. Circ Arrhythmia Electrophysiol. 2013;6(1):76–83. CrossRef
Poon K, Okin PM, Kligfield P. Diagnostic performance of a computer-based ECG rhythm algorithm. J Electrocardiol. 2005;38(3):235–8. CrossRef
Stritzke J, Markus MRP, Duderstadt S, et al. The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging. J Am Coll Cardiol. 2009;54(21):1982. CrossRef
Cuspidi C, Meani S, Fusi V, et al. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study. J Hypert. 2005;23(4):875–82. CrossRef
Gottdiener JS, Reda DJ, Williams DW, Materson BJ. Left Atrial Size in Hypertensive Men: Influence of Obesity, Race and Age fn1fn1Financial support was provided by the Cooperative Studies Program of the Medical Research Service of the Department of Veterans Affairs. J Am Coll Cardiol. 1997;29(3):651–8. CrossRef
Fernandes-Cardoso A, Santos-Furtado M, Grindler J, et al. Epicardial fat thickness correlates with P‑wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity. NMCD. 2017;27(8):731–8. PubMed
Pucci G, Battista F, de Vuono S, et al. Pericardial fat, insulin resistance, and left ventricular structure and function in morbid obesity. Nutrition, metabolism, and cardiovascular diseases. NMCD. 2014;24(4):440–6. PubMed
Watanabe K, Kishino T, Sano J, et al. Relationship between epicardial adipose tissue thickness and early impairment of left ventricular systolic function in patients with preserved ejection fraction. Heart Vessels. 2016;31(6):1010–5. CrossRef
Friedman DJ, Wang N, Meigs JB, et al. Pericardial fat is associated with atrial conduction: the Framingham Heart. Study Jaha. 2014;3(2):e477. PubMed
Al-Rawahi M, Proietti R, Thanassoulis G. Pericardial fat and atrial fibrillation: Epidemiology, mechanisms and interventions. Intern J Cardiol. 2015;195:98–103. CrossRef
Hatem SN, Redheuil A, Gandjbakhch E. Cardiac adipose tissue and atrial fibrillation: the perils of adiposity. Cardiovasc Res. 2016;109(4):502–9. CrossRef
Okin PM, Roman MJ, Devereux RB, Kligfield P. ECG identification of left ventricular hypertrophy. Relationship of test performance to body habitus. J Electrocardiol. 1996;29(Suppl):256–61. CrossRef
Weinsaft JW, Kochav JD, Kim J, et al. P wave area for quantitative electrocardiographic assessment of left atrial remodeling. PLoS ONE. 2014;9(6):e99178. CrossRef
Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. 1949. Ann Noninvasive Electrocardiol. 2001;6(4):343–68. CrossRef
Molloy TJ, Okin PM, Devereux RB, Kligfield P. Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product. J Am Coll Cardiol. 1992;20(5):1180–6. CrossRef
Fridericia LS. The duration of systole in an electrocardiogram in normal humans and in patients with heart disease. 1920. Ann Noninvasive Electrocardiol. 2003;8(4):343–51. CrossRef
- Body mass index related electrocardiographic findings in healthy young individuals with a normal body mass index
G. J. Hassing
H. E. C. van der Wall
G. J. P. van Westen
M. J. B. Kemme
- Bohn Stafleu van Loghum
Netherlands Heart Journal
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250