DocumentsDate added
Original article
Kranthi Kumar G1,*, Tripura Lakshmi J2, Bindu Garg3, Ashish Goel3
Affiliation:-
1Demonstrator, 3Associate Professor, Department of Physiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, U.P., India
2Demonstrator, Department of Physiology, Rohilkhand Medical College & Hospital, Bareilly, U.P.,India
4Assistant Professor, Department of Physiology, Shri Dev Suman Subharti Medical College, Dehradun, UP.,India
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Physiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, U.P., India
2.Department of Physiology, Rohilkhand Medical College & Hospital, Bareilly, U.P., India
3.Departmtent of Physiology, Shri Dev Suman Subharti Medical College, Dehradun, U.K., India
Address reprint requests to
Dr. Kranthi Kumar Garikapati.
Department of Physiology, SRMS IMS, Bareilly, U.P, India
Article citation: Garikapati KK, Lakshmi T, Garg B, Goel A. Study of mean cardiac axis of electrocardiogram on young Adults. J Pharm Biomed Sci. 2014; 04(10):887-893. Available at www.jpbms.info
ABSTRACT
Introduction: Obesity is a condition with excess of body fat in an individual. As per WHO data in 2005 there were about 400 million obese adults worldwide. Obesity is a most important predisposing factor for cardiovascular morbidity and mortality. Determination of mean cardiac axis (MCA) assisted in the diagnosis of early changes in the cardiovascular system. Obese people tend to have high resting heart rate, high blood pressure and leftward shift of the mean cardiac axis.
Aims: The present study was aimed to describe the impact of obesity on blood pressure and mean cardiac axis in healthy young adult individuals.
Materials and Methods: The study included 71 young adult individuals with age between 18-30 years. These were divided into 5 categories as per WHO classification of body mass index (BMI). Anthropometric parameters, pulse and blood pressure were recorded. MCA was determined from the standard bipolar limb lead electrocardiogram.
Statistical analysis: Using Microsoft Excel 10 data was analyzed. Values were depicted as mean ± SD & Pearson correlation was performed.
Results: It was noted that body surface area (BSA), waist circumference (WC), hip circumference (HC), systolic & diastolic blood pressure (SBP & DBP) increased with increment in BMI. It was also noted that MCA showed a leftward shift when normal BMI subjects were compared with obese subjects, though it was still within the normal range. BMI, BSA and WC had a significant negative correlation with mean cardiac axis.
Conclusion: Obesity based on BMI and WC adversely affects the blood pressure and mean cardiac axis.
KEYWORDS: Obesity; Mean cardiac axis; Electrocardiogram; Body mass index; Waist circumference.
REFERENCES
1.Low S, Chin MC, Ma S, Heng D, Deurenberg Y. Rationale for Redefining Obesity in Asians. Ann Acad Med Singapore 2009; 38:66-74.
2.Sung JK, Kim JY. Obesity and Preclinical Changes of Cardiac Geometry and Function. Korean Circ J 2010; 40:55-61.
3.Hamoda MGA, Caldwell MA, Stotts NA, Drew BJ et al. Factors to Consider When Analyzing 12-Lead Electrocardiograms for Evidence of Acute Myocardial Ischemia: American Journal of Critical Care: 2003;12: 9-18.
4.Frank S, Colliver JA, Frank A. The electrocardiogram in obesity Statistical Analysis of 1029 Patients: J Am Coll Cardiol, 1986;7:295-99.
5.Conover MB. Understanding electrocardiography. 8th ed. St. Louis (MO): Mosby; 2003.
6.Aehlert B. ECGs made easy. 3rd ed. St. Louis (MO): Mosby; 2006.
7.Alspach J. Electrical axis: how to recognize deviations on the ECG and interpret them. Am J Nurs 1979;79:1976-83.
8.Huszar RJ. Basic dysrhythmias: interpretation and management. 3rd ed (revised). St. Louis (MO): Mosby; 2007.
9.Ganong WF: Review of Medical physiology: 22nd ed : 2005,553.
10.Tilley P, Peterson D. Pulling axis together. Dimens Crit Care Nurs 2003;22:210-5.
11.Kuhn L, Rose L. ECG interpretation part 1: Understanding mean electrical axis. J Emerg Nurs. 2008; 34(6):530-534.
12.WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004; 363: 157–63.
13.Flegal KM, Carroll MD, Kuczmarski RJ et al. Overweight and Obesity in the United States: Prevalence and trends; Int J Obese related metabolic disorders, 1998;22:39-47.
14.DuBois D; DuBois EF: A formula to estimate the approximate surface area if height and weight be known. Arch Int Med 1916; 17:863-71.
15.Garg B, Yadav N, Vardhan H, DE AK. Asymptomatic Obese Hypertensives and Need of Routine Echocardiography for Left Ventricular Mass Assessment and Treatment. Journal of Clinical and Diagnostic Research. 2013;7(8): 1599-1603.
16.Tumuklu MM, Etikan I, Kisacik B, et al. Effect of obesity on left ventricular structure and myocardial systolic function: assessment by tissue Doppler imaging and strain/ strain rate imaging. Echocardiography 2007; 24:802-9.
17.Alpert MA. Obesity cardiomyopathy: Pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001; 321:225- 36.
18.Staessen J, Fagard R, Amery A. The relationship between body weight and blood pressure. Journal of Human Hypertension. 1988;2: 207-17
19.Zhu H, Yan W, Ge D et al. Relationships of Cardiovascular Phenotypes With Healthy Weight, at Risk of Overweight, and Overweight in US Youths. Pediatrics. 2008; 121;115.
20.Chadha DS, Swamy A, Malani SK et al. Impact of Body Mass Index on Left Ventricular Function. MJAFI 2009; 65: 203-07.
21.Luskin J, Whipple H. Effects of Age and Habitus upon the Mean Electrical Axis of the Electrocardiogram in Normal Males: Ann Intern Med.1961;55(4):610-619.
22.Fraley MA, Birchem JA, Senkottaiyan N, Alpert MA. Obesity and the electrocardiogram. IASO 2005; 6(4):275–281.
23.Kathrotia RG, Paralikar SJ, Rao PV, Oommen ER. Impact of different grades of body mass index on Left ventricular structure and function. Indian J Physiol Pharmacol. 2010; 54 (2) : 149–56.
24.Sun GZ, Li Y, Zhou HX, Zuo XF, Zhang XG, Zheng LQ et al. Association between obesity and ECG variables in children and adolescents: A cross-sectional study. Experimental and Therapeutic Medicine 2013; 6: 1455-1462.
Source of support: None
Competing interest / Conflict of interest:
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Garikapati KK, Lakshmi T,Garg B, Goel A. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.