Does obesity have an effect on the ECG in children?

2020 ◽  
Vol 33 (5) ◽  
pp. 585-589
Author(s):  
Alexandra Kiess ◽  
Antje Körner ◽  
Ingo Dähnert ◽  
Mandy Vogel ◽  
Franziska Markel ◽  
...  
Keyword(s):  
Heart Rate ◽  
Childhood Obesity ◽  
Left Ventricular ◽  
P Wave ◽  
Left Ventricular Geometry ◽  
Qtc Interval ◽  
Obese Children ◽  
Obese Adults ◽  
Study Results ◽  
Ecg Alterations

AbstractThis review summarizes current data on influences of childhood obesity on the 12-lead electrocardiogram (ECG). Studies on obese adults showed a higher risk of cardiovascular complications and also, partly pathological, ECG alterations. Data on ECG alterations in obese children is rare. In current studies, no pathological findings were found. All alterations, which mimic the later pathological phenomena in obese adults, were within normal ranges. Studies reported significantly longer P-wave time and P-wave dispersion (Pd) in obese children [Üner A, Doğan M, Epcacan Z, Epçaçan S. The effect of childhood obesity on cardiac functions. J Pediatr Endocr Met 2014;27:261–71.], no correlation of heart rate, P-wave, or QT dispersions (QTd) [Akyüz A, Alpsoy S, Akkoyun DC, Nalbantoǧlu B, Tülübaș F, et al. Effect of overweight on P-wave and QT dispersions in childhood. Turk Kardiyol Dern Ars 2013;41:515–21.], significantly higher QTd in obese children [Yildirim S, Binnetoglu FK, Battal F, Aylanc H, Nazan Kaymaz N, et al. Relation between QT variables and left ventricular geometry in athletes and obese children. Acta Med Port 2016;29:95–100.], no significant association between obesity and QTc interval (QTc), but longer PR intervals, wider QRS duration and left axis shifting of frontal P-wave, QRS and T-wave axes [Sun G, Li Y, Zho X, Guuo X, Zhang X, et al. Association between obesity and ECG variables in children and adolescents: a cross-sectional study. Exp Ther Med 2013;6:1455–62.], significant prolongation of QTc, T peak-to-end, and QTd in the obese children [Paech C, Liebold A, Gebauer RA, Wagner F, Vogel M, et al. Relative QT interval prolongation and electrical inhomogeneity of cardiac repolarization in childhood obesity. Prog Pediatr Cardiol 2017;47:64–7.], slight shift to the left in the QRS axis (with no changes in the P axis), increased amplitudes of the left-sided leads in obese children, and no correlation of the heart rate with the weight [Paech C, Anhalt M, Gebauer RA, Wagner F, Vogel M, et al. New normal limits for pediatric ECG in childhood obesity? Influence of childhood obesity on the ECG. Prog Pediatr Cardiol 2018;48:119–23.]. Altogether, the study results are inconsistent. Clearly, pathological phenomena in the ECG of obese children were not reported: only preliminary stages like QTc prolongation within the norm were found. The pathological alterations seen in adult obese patients are not (yet) seen in childhood. The slight changes reported in childhood obesity are likely to manifest later and to develop into pathological phenomena in obese adults and, therefore, might increase the risk of cardiovascular events like arrhythmia and sudden cardiac death in adulthood.

Electrocardiographic Predictors of Cognitive Decline and Dementia: A Systematic Review

2021 ◽  
pp. 1-20
Author(s):  
Yume Imahori ◽  
Davide L. Vetrano ◽  
Petter Ljungman ◽  
Chengxuan Qiu
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Cognitive Decline ◽  
Prospective Studies ◽  
Left Ventricular ◽  
Qt Prolongation ◽  
P Wave ◽  
Cross Sectional ◽  
Incident Dementia ◽  
Electrocardiogram Ecg

Background: Markers of altered cardiac function might predict cognitive decline and dementia. Objective: This systematic review aims to review the literature that examines the associations of various electrocardiogram (ECG) markers with cognitive decline and dementia in middle-aged and elderly populations. Methods: We searched PubMed, Embase, and Web of Science through 1 July 2020 for literature and conducted a systematic literature review. We included studies examining the associations of ECG markers (e.g., left ventricular hypertrophy [LVH], spatial QRS-T angle, and QT prolongation) with cognitive function and dementia in adult populations regardless of study setting and design, but excluded studies examining atrial fibrillation and heart rate variability. Results: Fourteen community-based cross-sectional and longitudinal studies were identified. ECG markers were investigated in association with dementia in four prospective studies, and with cognitive decline in ten prospective studies. ECG-assessed LVH was associated with dementia in one study while five heterogeneous prospective studies yielded inconsistent associations with cognitive decline. Regarding ventricular repolarization markers, spatial QRS-T angle was associated with cognitive decline in one study while another study found no association between QT prolongation and cognitive decline. High resting heart rate was associated with both dementia and cognitive decline in one study but not associated with dementia in another study. P-wave abnormality was significantly associated with incident dementia and cognitive decline in one prospective study. Conclusion: Some ECG markers were associated with incident dementia and cognitive decline. However, limited number of heterogeneous studies did not allow us to make firm conclusions. Further studies are needed.

scholarly journals Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism

2020 ◽  
Vol 66 (12) ◽  
pp. 1657-1665
Author(s):  
Yakup Alsancak ◽  
Ahmet Taha Sahın ◽  
Ahmet Seyfeddin Gurbuz ◽  
Ahmet Lutfi Sertdemir ◽  
Abdullah Icli ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Thrombolytic Therapy ◽  
Statistical Significance ◽  
Early Period ◽  
P Wave ◽  
P Value ◽  
Qtc Interval ◽  
P Wave Dispersion

SUMMARY OBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT. First, the high-risk APE patients’ ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups’ ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group ( P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group ( P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio ( P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P -value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT ( P -value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT. It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.

Serum uric acid and left ventricular geometry pattern in obese children

2019 ◽  
Vol 40 ◽  
pp. 88-93
Author(s):  
Bojko Bjelakovic ◽  
Claudia Stefanutti ◽  
Dejan Bonic ◽  
Vladimir Vukovic ◽  
Nebojsa Kavaric ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Obese Children ◽  
Ventricular Geometry

Age-Specific Features of the Functional Development of the Circulatory System in Children Living in Northeastern Russia

2021 ◽  
pp. 34-38
Author(s):  
LI Grechkina ◽  
VO Karandasheva
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Peripheral Resistance ◽  
Left Ventricular ◽  
Human Interaction ◽  
Northeastern Russia ◽  
Special Importance ◽  
Functional Development ◽  
Age Related ◽  
Study Results

Summary. Introduction: The problem of human interaction with the environment acquires special importance nowadays. Significant migration processes observed in the last decade have become global, thus necessitating studies of the mechanisms of human adaptation to new environmental conditions. Our objective was to study age-related changes in functional indices of the cardiovascular system in adolescents between 11 and 17 years of age, born in Magadan in the first to third generation of Caucasians who had migrated to this city. Material and methods: In all, 1,442 school-age adolescents were examined including 809 boys and 633 girls. The main anthropometric parameters (body weight, kg, and height, cm) were measured and cardiac hemodynamics was determined at rest in the sitting position by volumetric compression oscillometry using a non-invasive hard- and software unit for central hemodynamic study. Results: Significantly higher values of cardiac output and stroke volume prevailed in boys of all age groups. The boys aged 14-17 years also demonstrated higher values of systolic blood pressure and left ventricular power output compared to girls. At the same time, the girls had higher age-specific indices of the heart rate, diastolic blood pressure, and total peripheral resistance. Conclusion: We established that the highest rates of cardiovascular functional development occur during puberty in 11 to 16-year-old boys and 11 to 13-year-old girls. Our findings showed that only 70.2 % to 77.2 % of the boys and 75.1 % to 80.2 % of the girls had blood pressure and heart rate readings within the age norm. Prehypertension was registered in 11.3 % and 10.3 % while hypertension was observed in 11.5 % and 9.5 % of the examined boys and girls, respectively. Tachycardia at rest was noted in 18 % of the boys and 20.2 % of the girls.

Abstract 18342: Inducible Cardiomyocyte-Specific Deletion of Stromal Interaction Molecules Results in Cardiomyopathy in Mice

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Saravanakumar Murugesan ◽  
Ryan D Sullivan ◽  
Salvatore Mancarella
Keyword(s):  
Heart Rate ◽  
Dilated Cardiomyopathy ◽  
Mammalian Cells ◽  
Calcium Release ◽  
Cardiac Contractility ◽  
Calcium Transient ◽  
Left Ventricular ◽  
P Wave ◽  
Calcium Sensors

Background: Stromal interaction molecules (STIM1 and STIM2) are sarco/endoplasmic calcium sensors ubiquitously expressed in mammalian cells. Upon Ca2+ store discharge STIM proteins oligomerize in proximity of the plasma membrane to activate the Ca2+ selective channels (Orai) and trigger Ca2+ entry. While this mechanism is widely accepted to be the main source of calcium in non-excitable cells, in cardiomyocytes the calcium-induced calcium-release is the major controller of myocardial function, and the presence of STIM in these cells appears somewhat puzzling. Here we investigated the role of STIM in cardiomyocytes and its role in regulating cardiac contractility and intracellular Ca2+ dynamics. Methods: We have generated an inducible cardiac-specific STIM1 knockout (STIM KO) mouse model to elucidate the role of STIM in the myocardium. Echocardiography was used to evaluate structure and function of the left ventricle. Heart rate was monitored continuously in conscious mice by telemetry. Cell dimensions, shortening, and relaxation were determined by videomicroscopy and calcium transients by fura 2. Results: Echocardiographic analyses revealed development of dilated cardiomyopathy with a significant reduction of left ventricular fractional shortening (39.91±4.05% vs. 22.41±7.92%, p<0.01). Histological and morphological analyses confirmed a dilated cardiomyopathy characterized by enlarged ventricular chambers. Electrocardiography showed higher heart rate in the STIM1 KO mice with no differences in P-wave duration and QRS interval while Q-T interval was reduced in the STIM1 KO mice as compared to the WT mice. Sarcomere length and cell shortening measurements in freshly isolated cardiomyocytes from STIM1 KO mice confirmed the reduced contractility associated with a reduction of time to 50% relaxation (283±13ms vs. 258±8ms, p<0.05) . Intracellular calcium transient analysis in STIM1 KO cardiomyocytes showed a higher peak amplitude and a time to 50% decay of calcium significantly accelerated. Conclusions: Our data demonstrate that STIM proteins play an important role in the maintaining normal cardiac function in the adult heart and reveal that STIM plays an important role during cardiac repolarization.

Does obesity influence ventricular repolarisation in children?

2020 ◽  
pp. 1-9
Author(s):  
Nihan Yıldırım Yıldız ◽  
Tayfun Uçar ◽  
Mehmet G. Ramoğlu ◽  
Merih Berberoğlu ◽  
Zeynep Şıklar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Body Mass ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Normal Weight ◽  
Qtc Interval ◽  
Healthy Children ◽  
Obese Children ◽  
Ventricular Repolarisation

Abstract Objective: Ventricular repolarisation changes may lead to sudden cardiac death in obese individuals. We aimed to investigate the relationship between ventricular repolarisation changes, echocardiographic parameters, anthropometric measures, and metabolic syndrome laboratory parameters in obese children. Methods: The study involved 81 obese and 82 normal-weight healthy children with a mean age of 12.3 ± 2.7 years. Anthropometric measurements of participants were evaluated according to nomograms. Obese patients were subdivided into two groups; metabolic syndrome and non-metabolic syndrome obese. Fasting plasma glucose, fasting insulin, and lipid profile were measured. QT/QTc interval, QT/QTc dispersions were measured, and left ventricular systolic and diastolic measurements were performed. Results: Body weight, body mass index, relative body mass index, waist/hip circumference ratio, and systolic and diastolic blood pressures were significantly higher in obese children. QT and QTc dispersions were significantly higher in obese children and also obese children with metabolic syndrome had significantly higher QT and QTc dispersions compared to non-metabolic syndrome obese children (p < 0.001) and normal-weight healthy children (p < 0.001). Waist/hip circumference ratio, body mass index, and relative body mass index were the most important determinant of QT and QTc dispersions. Left ventricular wall thickness (left ventricular posterior wall thickness at end-diastole, left ventricular posterior wall thickness at end-systole, interventricular septal thickness at end-diastole) and left ventricular mass index were significantly higher and ejection fraction was lower in obese children. Left ventricular mass index and interventricular septal thickness at end-diastole were positively correlated with QT and QTc dispersions. Conclusions: Our study demonstrated that QT/ QTc interval prolongation and increase in QT and QTc dispersion on electrocardiogram may be found at an early age in obese children.

scholarly journals The ECG changes in various comorbidities with hypertension and without hypertension

2020 ◽  
Vol 8 (4) ◽  
pp. 1351
Author(s):  
Metta Anil Kumar ◽  
J. Muralikrishna ◽  
Anand Acharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
P Wave ◽  
Study Group ◽  
Qtc Interval ◽  
Epidemiologic Transition ◽  
Mortality And Morbidity ◽  
Pr Interval

Background: Hypertension is the commonest cardiovascular disorder posing a challenge to the societies in socioeconomic and epidemiologic transition. In India, Cardiovascular Diseases (CVDs) are estimated to be responsible for 1.5 million deaths annually. Indeed, it is estimated that by 2020, CVDs will be the largest cause of mortality and morbidity in India. To present study is designed to evaluate the variation of blood pressure and ECG wave forms among people hypertension with co morbidities (study group) and controls.Methods: The study included 50 people comorbidities with hypertension and 50 controls, each between ages 30-40 years from general population, and also from Medicine outpatient department, KIMS and RF Amalapuram. Detailed history from subjects, blood pressure (sitting position) and electrocardiogram was recorded during resting state in supine position. The ECG results were evaluated for various parameters like heart rate, P wave, PR interval, QRS complex etc.Results: There was significant increase in heart rate, systolic blood pressure as well as diastolic blood pressure in study group when compared to controls. Decrease in PR interval, decrease in QT interval, decrease in QTc interval, decrease in QRS axis in smokers when compared to controls.Conclusions: There was significant increase in heart rate in study group (smokers, diabetic) when compared to controls. There was significant increase in systolic blood pressure as well as diastolic blood pressure in study group (smokers, diabetics) when compared to controls. There was significant decrease in PR interval in smokers when compared to controls. There was significant decrease in QT and QTc interval in smokers when compared to controls.

scholarly journals Echocardiographic Evaluation of LV Function in Patients with Tachyarrhythmia and Reduced Left Ventricular Function in Response to Rhythm Restoration

2021 ◽  
Vol 10 (16) ◽  
pp. 3706
Author(s):  
Christian Schach ◽  
Thomas Körtl ◽  
Rolf Wachter ◽  
Lars S. Maier ◽  
Samuel Sossalla
Keyword(s):  
Heart Rate ◽  
Ejection Fraction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Ventricular Geometry ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Systolic Volume

Aims: Tachyarrhythmia due to atrial fibrillation (AF) is often associated with reduced left ventricular (LV) function and has been proposed to cause arrhythmia-induced cardiomyopathy (AIC). However, the precise diagnostics of AIC and reversibility after rhythm restoration are poorly understood. Our aim was to investigate systolic LV function in tachycardic AF and to evaluate the direct effect of rhythm restoration. Methods: We prospectively studied 24 patients (71% male, age 65 ± 9 years) with tachycardic AF and newly diagnosed reduced left ventricular ejection fraction (LVEF). Just before and immediately after electrical cardioversion (ECV), transthoracic echocardiography was performed. Geometric as well as functional data were assessed. Results: Patients presented with a heart rate (HR) of 117.4 ± 21.6/min and a 2D-/3D-LVEF of 32 ± 9/31 ± 8%. ECV to sinus rhythm normalized HR to 77 ± 11/min with an increase of 2D-/3D-LVEF to 37 ± 9/37 ± 10% (p < 0.01 vs. baseline, each). Left ventricular geometry changed with an increase of end-diastolic volume (LVEDV) while end-systolic volume (LVESV) remained unchanged. Parameters concerning myocardial deformation (global longitudinal strain (GLS), strain rate (SR)) decreased whereas the RR interval-corrected GLS (GLSc) remained unchanged. In a simple linear regression model, GLS correlated with 2D- and 3D-LVEF not only before (pre) ECV, but also after (post) ECV. We demonstrate that the increase of LVEF and GLS (ratios pre/post) correlates with the change of HR (ΔHR; R2 = 0.20, 0.33 and 0.32, p < 0.05 each), whereas ratios of GLSc and SR do not significantly correlate with HR (R2 = 0.03 and 0.01, p = n.s. each). Conclusion: In patients with tachyarrhythmia and reduced ejection fraction, ECV leads to immediate improvement in EF and GLS while HR-corrected LV contractility remains unchanged. This suggests that the immediate effects of rhythm restoration are mostly related to changes in left ventricular volume, but not to an acute improvement of heart-rate independent contractility.

scholarly journals Lipid profile and left ventricular geometry pattern in obese children

2020 ◽  
Author(s):  
Bojko Bjelakovic ◽  
Claudia Stefanutti ◽  
Vladimir Vukovic ◽  
Nebojsa Kavaric ◽  
Ljiljana Saranac ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Serum Lipid ◽  
Ventricular Hypertrophy ◽  
Density Lipoprotein ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Obese Children ◽  
Ventricular Geometry ◽  
The Relationship ◽  
Age And Sex

Abstract Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children. Patients and methods : In this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG / HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-hour ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses with stepwise selection were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex. Results : Our study included 70 children (65.71% boys and 34.29% girls) with median age (14 years, IQR=12-16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24h-average SBP with LVMI (effect=3.65, SE=1.32, p<0.01; effect=34.90, SE=6.84, p<0.01; effect=0.32, SE=0.12, p<0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect=13.07, SE=5.02, p=0.01 Insulin: effect=2.80, SE=0.97). Conclusion: Increased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.

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