Correlation between body mass index and electrocardiogram parameters in healthy adults

Funding Acknowledgements

Type of funding sources: None.

Background

The electrocardiogram (ECG) is a tool to evaluate cardiac function. Its interpretation depends on age, sex and race.

Aims

to evaluate the association between body mass index (BMI) and electrocardiogram parameters in healthy adults.

Methods

We conducted a prospective study that included apparently healthy volunteers aged between 18 and 65 years. Body mass index was calculated and standard 12-lead ECG was recorded for all participants. Subjects were classified into four groups according to BMI: underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2). Pearson correlation coefficients were calculated to assess the relationship between ECG variables and BMI.

Results

 One hundred seventy-four apparently healthy volunteers (99 women and 75 men; age ranged from 18 to 65 years) were included in this study. The mean BMI was 26,36 ± 6,04 kg/m² with a minimum of 14,53 and a maximum of 49,27. Twenty-two (12,6%) subjects were in the underweight range; 53 (30,5%) in the normal weight range, 54 (31%) in the overweight range and 45 (25,9%) were obese. The results of our study showed a significant positive correlation between the ECG variables studied and the BMI except for HR and Sokolow index (table 1).

Conclusion

We concluded that BMI caused a significant modification in several ECG parameters in healthy adults. Increased BMI leads to lengthening of conduction times and ventricular repolarization. Largest investigation on the use of BMI-specific ECG norms is warranted. Table 1 ECG parameters BMI R-value P value HR -0,041 0,590 P wave duration 0,222 0,003 PR Interval 0,200 0,008 QRS duration 0,235 0,002 QT Interval 0,152 0,045 QTcorrected (QTc) 0,150 0,049 Sokolow index 0,102 0,182 Pearson correlation coefficients of various ECG parameters with BMI in the study population (n = 174)

Speckle tracking echocardiography in systemic sclerosis: A useful method for detection of myocardial involvement

BACKGROUND

Systemic sclerosis is a multisystem disorder characterized by tissue fibrosis and organ damage. Heart involvement is one of the main factors shortening survival, which may be underestimated by conventional echocardiography measurements. Two-dimensional speckle-tracking echocardiography is a powerful novel modality to assess subclinical myocardial dysfunction.

AIM

The aim of this study is to investigate heart involvement in systemic sclerosis patients, and to determine the usefulness of ventricular longitudinal deformation using the Two-dimensional speckle tracking technology for an early detection of ventricular dysfunction.

PATIENTS AND METHODS

Between May 2016 and September 2016, 25 patients with systemic sclerosis and 25 healthy subjects underwent echocardiography to assess heart abnormalities and the strain of the two ventricles using two dimensions' speckle tracking echography.

RESULTS

The two groups were comparable in age and gender. Despite comparable left ventricle systolic function (left ventricular ejection fraction patients 64.58±8.87 vs. in healthy 68.2±7.41, P=0.19), patients presented altered longitudinal peak systolic strain values (global longitudinal strain: patients -17.42±1.62 vs. healthy -19.24±8.85, P<0.0001). Despite comparable pulmonary artery systolic pressure, there was a significant alteration in right ventricular systolic and diastolic function assessed by standard measurement. Longitudinal peak systolic strain of the right ventricle was significantly lower in patients compared with controls (P<0.01).

CONCLUSION

Ventricular deformation analysis by two dimensions' speckle tracking echocardiography appears to be a sensitive method to detect early ventricular impairment in patients with systemic sclerosis.

[Results of percutaneous mitral balloon commissurotomy in pregnant women about 12 cases]

INTRODUCTION

Mitral stenosis (MS) is the most common valvular heart disease revealed or exacerbated by pregnancy. Percutaneous mitral balloon commissurotomy (PMC) is currently the treatment of choice when mitral valve morphology is favorable.

AIM OF THE STUDY

The purpose of this study is to evaluate the immediate, medium and long term results of percutaneous mitral balloon commissurotomy in pregnant women with a severe symptomatic mitral stenosis despite medical treatment.

PATIENTS AND METHODS

It is a retrospective study including 12 pregnant patients diagnosed with severe mitral stenosis and hospitalized in the cardiology department of Habib Thameur hospital between 1994 and 2014. A clinical and ultrasonographic monitoring was performed for over 15 years.

RESULTS

Mean patients age was 31.5±4.4 years. All patients were in NYHA class III or IV despite medical treatment. Mitral regurgitation was rated as moderate in four cases. Functional improvement was observed in all cases immediately after the procedure. Mitral valve area increased from 1.02±0.5cm² averaged to 2±0.35cm². Mitral regurgitation increased in three cases and appeared in two cases. All patients delivered at term. Newborns were all healthy. Two of them had a low birth weight. On the long term follow-up (95.58±64.1 months), five patients had mitral restenosis: two had a surgical valve replacement and three underwent a second percutaneous mitral balloon commissurotomy.

CONCLUSION

The effectiveness of the percutaneous mitral balloon commissurotomy is clearly documented by clinical and echocardiographic evaluation. In the case of pregnancy, the goal is not so much to obtain an optimal result but to cause hemodynamic improvement authorizing the continuation of pregnancy and childbirth.

[A multicenter study on profile of hypertension in focal segmental glomerulosclerosis in Tunisia]

Hypertension in focal segmental glomerulosclerosis is frequent and responsible for the progression of the disease. It could be a circumstance of the diagnosis of FSG or a complication of the nephrotic syndrome.

PURPOSE

To determine the prevalence of hypertension among patients with FSG diagnosed in Tunisia and to describe the profile of patients with FSG having hypertension in contrast with who do not.

PATIENTS AND METHODS

It was a retrospective multicentric study based on 116 patient files having FSG located in 5 specialized centers in Tunisia.

RESULTS

The prevalence of hypertension among our patients was 41%, with a feminine predominance, their mean age was 36.34 ± 15.71 years. The systolic blood pressure among the patients with hypertension was 153.18 mmHg. The nephrotic syndrome was impure due to hypertension in 14.5% of the cases. The patients affected by hypertension were more obese. Proteinuria was higher among those not having hypertension than those with it, who score an average value of 5.67 ± 4.51 g/24h, with an insignificant difference. Serum creatinine at presentation was significantly higher among patients with hypertension. Vascular lesions were present at the renal biopsy among 39.45% of patients affected by hypertension, associated with renal failure in 58.50% of patients. The etiopathogenic treatment of FSG was essentially based on steroids full dose.

CONCLUSION

Hypertension is often present in FSG and its' treatment must be as soon as possible in order to slow the progression of kidney chronic disease.

[Systemic sarcoidosis and membranous glomerulonephritis]

Renal involvement in sarcoidosis is rare and more often related to calcium metabolism disorders or granulomatous interstitial nephritis. Glomerulonephritis is exceptional. There may be a long latency period between the development of active sarcoidosis and glomerular involvement and inversely. We report a case membranous glomerulonephritis revealing systemic sarcoidosis.

A case of exorbitism in association with Wegener's granulomatosis with renal involvement

Wegener's granulomatosis (WG) is a necrotizing granulomatous vasculitis involving the nose, paranasal sinuses, lungs, and kidneys. Ocular involvement can occur in about 50% of cases. There are very few reports of WG with orbital inflammation and exorbitism. We report a case of a female patient who presented with exorbitism related to orbital inflammation secondary to WG, with renal involvement. A 29-year-old woman with a previous history of recurrent pan-sinusitis presented with bilateral exophthalmos and renal failure with rapidly progressive glomerulonephritis. Computed tomography showed extensive bilateral soft tissue in the retro-orbital area. Immunologic tests showed the presence of type-C anti-neutrophil cytoplasmic antibodies and renal biopsy revealed pauci immune crescentic glomerulonephritis. The patient was treated with corticosteroids and pulses of cyclophosphamide followed by azathioprine and trimethoprim-sulfamethoxazole. After a follow-up of 10 months, the renal outcome was favorable with improvement of renal function but there was persistence of exorbitism and loss of visual function. Our case suggests that WG should be considered in the differential diagnosis of persistent bilateral exophthalmos. Prompt recognition of this early manifestation is important for the institution of early treatment.