Anatomical cardiac and electrocardiographic axes correlate in both upright and supine positions: an upright/supine CT study.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
24 10 2023
24 10 2023
Historique:
received:
16
05
2023
accepted:
20
10
2023
medline:
26
10
2023
pubmed:
25
10
2023
entrez:
24
10
2023
Statut:
epublish
Résumé
The correlation between the anatomical cardiac and electrocardiographic axes has been discussed for several years. Using upright computed tomography, this study aimed to reveal the relationship between the anatomical cardiac and electrocardiographic axes in both the supine and upright positions. Upright CT and standard supine CT were performed for healthy volunteers, following electrocardiography in both upright and supine position. On CT images, the coordinates of apex, the center of aortic valve (AV) and mitral valve (MV) were recorded, and the vectors and angles were calculated. Subcutaneous and visceral fat volume were semi-automatically calculated in a workstation. From a total 190 volunteers, 41 males were performed electrocardiography and included for this study. The QRS and anatomical axes (AV-apex and MV-apex axis) were significantly correlated in both supine and upright positions, while the angle of the AV-apex to Z axis was the most correlated (supine: r = - 0.54, p = 0.0002, upright: r = - 0.47, p = 0.0020). The anatomical axis moved in the dorsal and caudal directions from the supine to upright position. Multiple regression analysis revealed that the anatomical axis from the AV-apex to the Z-axis was determined according to age, body height, subcutaneous and visceral fat volumes.
Identifiants
pubmed: 37875545
doi: 10.1038/s41598-023-45528-y
pii: 10.1038/s41598-023-45528-y
pmc: PMC10598224
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
18170Informations de copyright
© 2023. Springer Nature Limited.
Références
Ashnan, R., Gardberg, M. & Byer, E. The normal human ventricular gradient. III. The relation between the anatomic and electrical axes. Am. Heart J. 26, 473–494 (1943).
doi: 10.1016/S0002-8703(43)90149-8
Hyman, A., Failey, R. B. & Ashman, R. A can the longitudinal anatomical axis of the ventricles be estimated from the electrocardiogram?. Am. Heart J. 36, 906–910 (1948).
doi: 10.1016/0002-8703(48)90284-1
pubmed: 18893574
Fowler, N. O. & Braunstein, J. R. Anatomic and electrocardiographic position of the heart. Circulation 3, 906–910. https://doi.org/10.1161/01.cir.3.6.906 (1951).
doi: 10.1161/01.cir.3.6.906
pubmed: 14848942
Dougherty, J. D. The relation of the frontal QRS axis to the anatomic position of the heart. J. Electrocardiol. 3, 267–284. https://doi.org/10.1016/s0022-0736(70)80054-1 (1970).
doi: 10.1016/s0022-0736(70)80054-1
pubmed: 5517588
Meek, W. J. & Wilson, A. The effect of changes in position of the heart on the QRS complex of the electrocardiogram. Arch. Intern. Med. 36, 614–627 (1925).
doi: 10.1001/archinte.1925.00120170023002
Engblom, H., Hedström, E., Palmer, J., Wagner, G. S. & Arheden, H. Determination of the left ventricular long-axis orientation from a single short-axis MR image: Relation to BMI and age. Clin. Physiol. Funct. Imaging 24, 310–315. https://doi.org/10.1111/j.1475-097X.2004.00569.x (2004).
doi: 10.1111/j.1475-097X.2004.00569.x
pubmed: 15383089
Engblom, H. et al. The relationship between electrical axis by 12-lead electrocardiogram and anatomical axis of the heart by cardiac magnetic resonance in healthy subjects. Am. Heart J. 150, 507–512. https://doi.org/10.1016/j.ahj.2004.10.041 (2005).
doi: 10.1016/j.ahj.2004.10.041
pubmed: 16169332
Foster, J. E. et al. Determination of left ventricular long-axis orientation using MRI: changes during the respiratory and cardiac cycles in normal and diseased subjects. Clin. Physiol. Funct. Imaging 25, 286–292. https://doi.org/10.1111/j.1475-097X.2005.00624.x (2005).
doi: 10.1111/j.1475-097X.2005.00624.x
pubmed: 16117732
Sathananthan, G. et al. Computed tomography-guided in vivo cardiac orientation and correlation with ECG in individuals without structural heart disease and in age-matched obese and older individuals. Clin. Anat. 28, 487–493. https://doi.org/10.1002/ca.22532 (2015).
doi: 10.1002/ca.22532
pubmed: 25832755
Jinzaki, M. et al. Development of upright computed tomography with area detector for whole-body scans: Phantom study, efficacy on workflow, effect of gravity on human body, and potential clinical impact. Investig. Radiol. 55, 73–83. https://doi.org/10.1097/rli.0000000000000603 (2020).
doi: 10.1097/rli.0000000000000603
Yamada, Y. et al. Differences in lung and lobe volumes between supine and standing positions scanned with conventional and newly developed 320-detector-row upright CT: Intra-individual comparison. Respiration 99, 598–605. https://doi.org/10.1159/000507265 (2020).
doi: 10.1159/000507265
pubmed: 32640453
Yokoyama, Y. et al. Effect of gravity on brain structure as indicated on upright computed tomography. Sci. Rep. 11, 392. https://doi.org/10.1038/s41598-020-79695-z (2021).
doi: 10.1038/s41598-020-79695-z
pubmed: 33431952
pmcid: 7801697
Yagi, F. et al. Three-dimensional evaluation of the coccyx movement between supine and standing positions using conventional and upright computed tomography imaging. Sci. Rep. 11, 6886. https://doi.org/10.1038/s41598-021-86312-0 (2021).
doi: 10.1038/s41598-021-86312-0
pubmed: 33767271
pmcid: 7994836
Nakahara, T. et al. Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery. Sci. Rep. 11, 11602. https://doi.org/10.1038/s41598-021-90998-7 (2021).
doi: 10.1038/s41598-021-90998-7
pubmed: 34078949
pmcid: 8172633
Goldberger, D. M. M. A. A. L. Electrocardiography. In Braunwald's heart disease: A textbook of cardiovascular medicine 12 edn (eds. Bonow Peter Libby, R. O. , Mann, D. L., Tomaselli, G. F., Bhatt, D. L., Solomon, S. D. & Braunwald, E.), Ch. 14, 141–174 (Elsevier, 2022).
Jacobson, F. l. Chest Radiography in Cardiovascular Disease. In Braunwald's heart disease: A textbook of cardiovascular medicine 12 edn (eds. Bonow Peter Libby, R. O., Mann, D. L., Tomaselli, G. F., Bhatt, D. L., Solomon, S. D. & Braunwald, E) ch. 17, 268–276 (Elsevier, 2022).
Dougherty, J. D. Change in the frontal QRS axis with changes in the anatomic positions of the heart. J. Electrocardiol. 3, 299–308. https://doi.org/10.1016/s0022-0736(70)80056-5 (1970).
doi: 10.1016/s0022-0736(70)80056-5
pubmed: 5517590
Dougherty, J. D. & Stoudt, H. W. The relation of frontal QRS axis to age and body build. J. Electrocardiol. 3, 285–298. https://doi.org/10.1016/s0022-0736(70)80055-3 (1970).
doi: 10.1016/s0022-0736(70)80055-3
pubmed: 5517589
Tahara, Y., Mizuno, H., Ono, A. & Ishikawa, K. Evaluation of the electrocardiographic transitional zone by cardiac computed tomography. J. Electrocardiol. 24, 239–245. https://doi.org/10.1016/0022-0736(91)90029-l (1991).
doi: 10.1016/0022-0736(91)90029-l
pubmed: 1919383
Stanley Nattel, G. F. T. Mechanisms of cardiac arrhythmias. In Braunwald's heart disease: A textbook of cardiovascular medicine 12edn (eds Bonow Peter Libby, R. O., Mann, D. L., Tomaselli, G. F., Bhatt, D. L., Solomon, S. D. & Braunwald, E) Ch. 62, 1163–1190 ( Elsevier, 2022).
Rodriguez, E. R. & Tan, C. D. Structure and anatomy of the human pericardium. Prog. Cardiovasc. Dis. 59, 327–340. https://doi.org/10.1016/j.pcad.2016.12.010 (2017).
doi: 10.1016/j.pcad.2016.12.010
pubmed: 28062264
Martin M. Lewinter, P. C. C., Allan L. Klein. Pericardial Diseases. In Braunwald's heart disease: A textbook of cardiovascular medicine 12edn (ed Bonow Peter Libby, R. O., Mann, D. L., Tomaselli, G. F., Bhatt, D. L., Solomon, S. D., Braunwald, E.) Ch. 86, 1615–1634 (Elsevier, 2022).
Boineau, J. P. & Spach, M. S. The relationship between the electrocardiogram and the electrical activity of the heart. J. Electrocardiol. 1, 117–124. https://doi.org/10.1016/s0022-0736(68)80014-7 (1968).
doi: 10.1016/s0022-0736(68)80014-7
pubmed: 4880817
Bachman, S., Sparrow, D. & Smith, L. K. Effect of aging on the electrocardiogram. Am. J. Cardiol. 48, 513–516. https://doi.org/10.1016/0002-9149(81)90081-3 (1981).
doi: 10.1016/0002-9149(81)90081-3
pubmed: 7270459
Rijnbeek, P. R. et al. Normal values of the electrocardiogram for ages 16–90 years. J. Electrocardiol. 47, 914–921. https://doi.org/10.1016/j.jelectrocard.2014.07.022 (2014).
doi: 10.1016/j.jelectrocard.2014.07.022
pubmed: 25194872
Zack, P. M., Wiens, R. D. & Kennedy, H. L. Left-axis deviation and adiposity: the United States Health and Nutrition Examination Survey. Am. J. Cardiol. 53, 1129–1134. https://doi.org/10.1016/0002-9149(84)90649-0 (1984).
doi: 10.1016/0002-9149(84)90649-0
pubmed: 6702692
Frank, S., Colliver, J. A. & Frank, A. The electrocardiogram in obesity: Statistical analysis of 1029 patients. J. Am. Coll. Cardiol. 7, 295–299. https://doi.org/10.1016/s0735-1097(86)80494-6 (1986).
doi: 10.1016/s0735-1097(86)80494-6
pubmed: 3944347
Bland, E. F. & White, P. D. The clikical significance of complete inversion of lead III of the human electrocardiogram. Am. Heart J. 6, 333–337 (1931).
doi: 10.1016/S0002-8703(31)90300-1
Simonson, E. & Keys, A. The effect of age and body weight on the electrocardiogram of healthy men. Circulation 6, 749–761. https://doi.org/10.1161/01.cir.6.5.749 (1952).
doi: 10.1161/01.cir.6.5.749
pubmed: 12988354
Jones, J., Srodulski, Z. M. & Romisher, S. The aging electrocardiogram. Am. J. Emerg. Med. 8, 240–245. https://doi.org/10.1016/0735-6757(90)90331-s (1990).
doi: 10.1016/0735-6757(90)90331-s
pubmed: 2184809
Massing, G. K. & James, T. N. Anatomical configuration of the His bundle and bundle branches in the human heart. Circulation 53, 609–621. https://doi.org/10.1161/01.cir.53.4.609 (1976).
doi: 10.1161/01.cir.53.4.609
pubmed: 1253382
Mori, S. et al. Association between the rotation and three-dimensional tortuosity of the proximal ascending aorta. Clin. Anat. 27, 1200–1211. https://doi.org/10.1002/ca.22452 (2014).
doi: 10.1002/ca.22452
pubmed: 25091125
Mirvis, D. M. et al. Instrumentation and practice standards for electrocardiographic monitoring in special care units. A report for health professionals by a task force of the Council on Clinical Cardiology American Heart Association. Circulation 79, 464–471. https://doi.org/10.1161/01.cir.79.2.464 (1989).
doi: 10.1161/01.cir.79.2.464
pubmed: 2644056