Key result
Obesity was associated with a more leftward rotation of both anatomical and electrical cardiac axes compared to age-matched normal BMI controls (P<0.0001).
Why the study?
Does obesity or older age alter the anatomical and electrical cardiac axes in individuals without structural heart disease?
Observational (n=124)
Does obesity or older age alter the anatomical and electrical cardiac axes in individuals without structural heart disease?
Obesity is associated with a leftward shift of both anatomical and electrical cardiac axes, whereas older age is associated with a leftward shift of only the electrical axis.
May warrant ECG axis adjustment in obesity; hypothesis-generating for mechanisms and outcomes in patients without structural heart disease.
The cardiac axis in a structurally normal heart is influenced by a number of factors. We investigated the anatomical and electrical cardiac axes in middle-aged individuals without structural heart disease and compared this with age-matched obese and older individuals without structural heart disease. A retrospective study of controls included those between 30 and 60 years old with a normal body mass index (BMI), who were then compared with obese individuals between 30 and 60 years old and with individuals more than 60 years old with a normal BMI. The anatomical cardiac axis was determined along the long axis by cardiac computed tomography (CT) and correlated with the electrical cardiac axis on a surface electrocardiogram (ECG) in the frontal plane. A total of 124 patients were included. In the controls (n = 59), the mean CT axis was 38.1° ± 7.8° whilst the mean ECG axis was 51.8° ± 26.6°, Pearson r value 0.12 (P = 0.365). In the obese (n = 36), the mean CT axis was 25.1° ± 6.2° whilst the mean ECG axis was 20.1° ± 23.9°, Pearson r value 0.05 (P = 0.808). In the older group (n = 29), the mean CT axis was 34.4° ± 9.1° whilst the mean ECG axis was 34.4° ± 30.3°, Pearson r value 0.26 (P = 0.209). Obese individuals have a more leftward rotation of both axes than age-matched normals (P <0.0001), which could be secondary to elevation of the diaphragm. Older individuals have a more leftward rotation only of their electrical cardiac axis (P = 0.01), which could be a normal variant or reflect underlying conduction disturbances in this age group.
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Sathananthan et al. (2015) conducted an observational in Without structural heart disease (n=124). Obesity and older age (exposures) vs. Age-matched normal BMI controls was evaluated on Anatomical cardiac axis by CT and electrical cardiac axis by ECG (p=<0.0001). Obesity was associated with a more leftward rotation of both anatomical and electrical cardiac axes compared to age-matched normal BMI controls (P<0.0001).
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