A Population‐wide study of electrocardiographic (ECG) norms and the effect of demographic and anthropometric factors on selected ECG characteristics in young, Southeast Asian males—results from the Singapore Armed Forces ECG (SAFE) study

Sia, Ching‐Hui; Dalakoti, Mayank; Tan, Benjamin Yq; Lee, Edward C. Y.; Shen, Xiayan; Wang, Kangjie; Lee, Joshua S.; Arulanandam, Shalini; Chow, Weien; Yeo, Tee Joo; Yeo, Khung Keong; Chua, Terrance; Tan, Ru San; Lam, Carolyn S.P.; Chong, Daniel

doi:10.1111/anec.12634

Cited by 20 publications

(13 citation statements)

References 39 publications

(63 reference statements)

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“…ECG screening is, however, influenced by a variety of factors, including demographics and anthropometrics. In addition, electrocardiographic parameters vary across different ethnicities compared with international norms [9]. To date, few studies have reported validation of this new criterion in Chinese populations [10,11].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

Xia

Zhang

et al. 2020

Cardiology

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Introduction: Based on a small sample of patients with hypertension, a few studies have reported that the newly proposed S D + SV 4 criterion for left ventricular hypertrophy (LVH) is better than traditional criteria. This study aimed to verify the diagnostic capability of the S D + SV 4 criterion in a Chinese population with or without hypertension and to analyze the factors affecting the diagnostic accuracy of LVH. Methods: A total of 248 patients with LVH or paroxysmal supraventricular tachycardia (PSVT) discharged from Fuwai Hospital from January 2010 to July 2018 were enrolled. Patients with LVH were diagnosed according to the left ventricular mass index calculated by the echocardiogram parameter as the gold standard in this study. The receiver operating curve (ROC) curve was performed to assess the diagnostic capability and cut-off values of the S D + SV 4 , RavL + SV 3 , and SV 1 + RV 5 /RV 6 criteria for LVH. Then, multi-variate logistic regression analyses were performed to investigate the factors affecting the accuracy of the S D + SV 4 criterion. Results: There were 170 (68.5%) patients with hypertension and 110 (44.4%) with PSVT. According to echocardiography, 107 (43.1%) patients were diagnosed with LVH. The area under the curve (AUC) of the S D + SV 4 criterion was the largest compared with that of the RavL + SV 3 and SV 1 + RV 5 /RV 6 criteria (AUC 0.765 vs. 0.718 vs. 0.713, respectively). The sex-specific S D + SV 4 criterion had the highest consistency with the gold standard (r = 0.532 ± 0.054, p < 0.01), accompanied by the highest sensitivity (70.1%) and specificity (85.8%). The cut-off values of the sex-specific S D + SV 4 criterion for LVH were ≥2.65 mV (male)/2.15 mV (female). The left ventricular ejection fraction (LVEF; OR 0.920, 95% CI 0.882-0.959, p < 0.001) was significantly different between the S D + SV 4 criterion and the gold standard for LVH after adjusting for hypertension, PSVT history, body surface area, interventricular septum thickness, posterior wall thickness, and left ventricular internal diameter. Conclusion: The newly proposed S D + SV 4 criterion provides improved sensitivity and accuracy for the diagnosis of LVH in the Chinese population. A decrease in LVEF is an independent factor affecting the diagnostic accuracy of LVH.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

Xia

Zhang

et al. 2020

Cardiology

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“…Ch. Sia et al (38) disclosed that systolic blood pressure of >140 mmHg or diastolic blood pressure of >90 mmHg independently increased the prevalence of increased QRS voltage on ECG. The current study ndings also indicated higher R wave amplitude in the patients with ischemic heart disease, while no signi cant ECG changes were found in those with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…ECG screening is commonly used to identify pathological processes, such as lethal arrhythmias associated with short-or long-term QT interval. Although such conditions rarely occur in young and healthy populations, early detection can prevent the catastrophic complications of sudden cardiac death (8). Due to the limited number of related studies conducted on the middle-aged population of Iran, this study aims to evaluate the relationship between demographic and anthropometric variables and ECG parameters in the middle-aged population of Fasa Persian cohort.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between demographic features, anthropometric parameters, sleep hours, and physical activity and ECG parameters in Fasa Persian cohort study

Mirahmadizadeh¹,

Farjam²,

Sharafi³

et al. 2021

Preprint

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Backgrounds: Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep time, and physical activity and ECG parameters in Fasa Persian cohort study. Methods: In this cross-sectional study, the basic information of 10,000 participants aged 35-70 years in Fasa cohort study was used. The information used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep time, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model. Results: The findings of this study suggested that increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference، hip circumference, and waist circumference significantly increased the mean values of the ECG parameters. However, sleep time was not significantly associated with the ECG parameters. In addition, hypertension was a major comorbidity, which was shown to increase the mean values of the ECG parameters. Conclusion: A number of factors affected the ECG parameters. Thus, in order to interpret ECGs, in addition to age and gender, anthropometric indices, physical activity, and previous history of comorbidities, such as hypertension and ischemic heart disease, should be taken into consideration.

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“…It has also been long understood 3 that in addition to the heart size and to the ventricular myocardial mass 4 , the duration of the QRS complex is influenced by the myocyte geometry and layer orientation 5 , Purkinje fibre tree structure 6 , and depolarising ion currents 7 . It is also known that compared to males, females have shorter QRS complex 8 , 9 , and that QRS duration disparities exist between races 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

Spatial distribution of physiologic 12-lead QRS complex

Hnatkova

Andršová

Toman

et al. 2021

Sci Rep

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The normal physiologic range of QRS complex duration spans between 80 and 125 ms with known differences between females and males which cannot be explained by the anatomical variations of heart sizes. To investigate the reasons for the sex differences as well as for the wide range of normal values, a technology is proposed based on the singular value decomposition and on the separation of different orthogonal components of the QRS complex. This allows classification of the proportions of different components representing the 3-dimensional representation of the electrocardiographic signal as well as classification of components that go beyond the 3-dimensional representation and that correspond to the degree of intricate convolutions of the depolarisation sequence. The technology was applied to 382,019 individual 10-s ECG samples recorded in 639 healthy subjects (311 females and 328 males) aged 33.8 ± 9.4 years. The analyses showed that QRS duration was mainly influenced by the proportions of the first two orthogonal components of the QRS complex. The first component demonstrated statistically significantly larger proportion of the total QRS power (expressed by the absolute area of the complex in all independent ECG leads) in females than in males (64.2 ± 11.6% vs 59.7 ± 11.9%, p < 0.00001—measured at resting heart rate of 60 beats per minute) while the second component demonstrated larger proportion of the QRS power in males compared to females (33.1 ± 11.9% vs 29.6 ± 11.4%, p < 0.001). The analysis also showed that the components attributable to localised depolarisation sequence abnormalities were significantly larger in males compared to females (2.85 ± 1.08% vs 2.42 ± 0.87%, p < 0.00001). In addition to the demonstration of the technology, the study concludes that the detailed convolution of the depolarisation waveform is individual, and that smoother and less intricate depolarisation propagation is the mechanism likely responsible for shorter QRS duration in females.

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A Population‐wide study of electrocardiographic (ECG) norms and the effect of demographic and anthropometric factors on selected ECG characteristics in young, Southeast Asian males—results from the Singapore Armed Forces ECG (SAFE) study

Cited by 20 publications

References 39 publications

Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

The relationship between demographic features, anthropometric parameters, sleep hours, and physical activity and ECG parameters in Fasa Persian cohort study

Spatial distribution of physiologic 12-lead QRS complex

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