Electrocardiographic changes and obesity

    Authors

    Keywords

    obesity, electrocardiographic changes, ECG analysis

    DOI

    https://doi.org/10.15836/ccar2016.529

    Full Text

    **Introduction:** Obesity is a major public health problem, many as 13% of the world population is obese. It is an independent factor for development of cardiovascular disease, diabetes, hypertension and hypercholesterolemia. (1-3) The aim of this study was to analyze certain electrocardiographic parameters in order to realize the difference between obese people and those with normal body weight. **Patients and Methods:** The study included 166 patients, of which 76 obese patients, mostly men aged 43.23 ± 12.43. The main selection criterion was the BMI greater than 30kg/m2. Exclusion criteria were known history of cardiovascular disease, electrocardiographic changes in the form of a block (left or right branch), atrial and/or ventricular extrasystoles, and previously known diabetes mellitus and arterial hypertension. **Results:** A comparative analysis of electrocardiograms found four significant differences. In obese patients electrical axis rotated more to the left than in the control group (21.64 ± 30.31 vs. 53.62 ± 31.21 degrees, p <0.001). Time depolarization of the atrium is also longer in obese based on changes in the size of the atrium ((P wave: 106 ms (62-186 ms) vs. 112 ms (58-162 ms) p = 0.01; PQ interval: 159.23 ± 25.07 ms vs. 148.77 ± 24.18 ms, p = 0.006)). Flattened / negative T waves of precordial drains were found in greater numbers in obese people; T waves on limb drains were found in greater numbers in healthy subjects. QRS, QTc and ST segment elevation were not significantly different between two groups. The study shows obese patients also have a higher blood pressure, over 8 mmHg systolic and 10 mmHg of diastolic blood pressure values (p <0.05). **Conclusion:** Minimum ECG changes such as increasing the atrial depolarization and change of final oscillations could be used in obese patients as a screening method for early detection of cardiac changes and identifying those in need of further processing.

    Literature

    1. Germano G. Electrocardiographic Signs of Left Ventricular Hypertrophy in Obese Patients: What Criteria Should be Used? High Blood Press Cardiovasc Prev. 2015;22:5–9. https://doi.org/10.1007/s40292-014-0062-3
    2. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. American Heart Association; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006;113(6):898–918. https://doi.org/10.1161/CIRCULATIONAHA.106.171016
    3. Wang S. Electrocardiographic Consequences Of Electrical And Anatomical Remodeling In Diabetic And Obese Humans. St. Luis: Washington University, 2009. ETDs.
    Cardiologia Croatica
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    Electrocardiographic changes and obesity

    Extended Abstract
    Issue10-11
    Published
    Pages529
    PDF via DOIhttps://doi.org/10.15836/ccar2016.529
    obesity
    electrocardiographic changes
    ECG analysis

    Authors

    Aleksandra Marković*ORCIDCounty Hospital Čakovec, Čakovec, Croatia
    Sandro BrusichUniversity of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka, Croatia
    Alen RužićORCIDUniversity of Rijeka School of Medicine, University Hospital Centre Rijeka, Rijeka, Croatia

    *Correspondence email: a.markovic0190@gmail.com

    Full Text

    Introduction: Obesity is a major public health problem, many as 13% of the world population is obese. It is an independent factor for development of cardiovascular disease, diabetes, hypertension and hypercholesterolemia. (1–3) The aim of this study was to analyze certain electrocardiographic parameters in order to realize the difference between obese people and those with normal body weight.

    Patients and Methods: The study included 166 patients, of which 76 obese patients, mostly men aged 43.23 ± 12.43. The main selection criterion was the BMI greater than 30kg/m2. Exclusion criteria were known history of cardiovascular disease, electrocardiographic changes in the form of a block (left or right branch), atrial and/or ventricular extrasystoles, and previously known diabetes mellitus and arterial hypertension.

    Results: A comparative analysis of electrocardiograms found four significant differences. In obese patients electrical axis rotated more to the left than in the control group (21.64 ± 30.31 vs. 53.62 ± 31.21 degrees, p <0.001). Time depolarization of the atrium is also longer in obese based on changes in the size of the atrium ((P wave: 106 ms (62-186 ms) vs. 112 ms (58-162 ms) p = 0.01; PQ interval: 159.23 ± 25.07 ms vs. 148.77 ± 24.18 ms, p = 0.006)). Flattened / negative T waves of precordial drains were found in greater numbers in obese people; T waves on limb drains were found in greater numbers in healthy subjects. QRS, QTc and ST segment elevation were not significantly different between two groups. The study shows obese patients also have a higher blood pressure, over 8 mmHg systolic and 10 mmHg of diastolic blood pressure values (p <0.05).

    Conclusion: Minimum ECG changes such as increasing the atrial depolarization and change of final oscillations could be used in obese patients as a screening method for early detection of cardiac changes and identifying those in need of further processing.

    Literature

    1. 1.
      Germano G. Electrocardiographic Signs of Left Ventricular Hypertrophy in Obese Patients: What Criteria Should be Used? High Blood Press Cardiovasc Prev. 2015;22:5–9.DOI
    2. 2.
      Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. American Heart Association; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006;113(6):898–918.DOI
    3. 3.
      Wang S. Electrocardiographic Consequences Of Electrical And Anatomical Remodeling In Diabetic And Obese Humans. St. Luis: Washington University, 2009. ETDs.