Effect of Body Build on the QRS Voltage of the Electrocardiogram in Normal Men

Various sets of QRS voltages that are used in the diagnosis of left ventricular hypertrophy were determined from the electrocardiograms of 300 normal men judged to be free from cardiopulmonary disease, and these were correlated to body build expressed in terms of ponderal index. A correlation was found for all voltages studied and a highly significant correlation was found for the criteria "R I + S III " "greatest R + greatest S in the precordial leads" and "greatest R + S in a single precordial lead." Age or activity did not appear to be specific factors in the population studied. Graphs were constructed for the latter three sets of voltages defining upper limits of normal for various values of the ponderal index. By using these sets of voltage criteria in conjunction with this index, one would hopefully improve both accuracy and specificity in the electrocardiographic diagnosis of early left ventricular hypertrophy.