Marín J A, Blume M, Galván J
Instituto Nacional de Cardiología, Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1988 Sep-Oct;58(5):419-24.
Although many factors have been reported to change the R wave amplitude of the electrocardiogram, the direct measurement without any consideration, has been the method of choice, which leads to controversial findings. We hypothesized that body mass index and heart position are the main modifiers of the R wave amplitude. To test this hypothesis 80 normal subjects were studied with standard electrocardiograms in which correlation with constitutional variables were performed and were also analyzed according to the electrocardiographic heart position. R wave amplitude showed a non-significant inverse relationship to body mass except in severe overweight subjects (p less than 0.05). When analyzed by position, levorotated and S1, S2, S3 hearts showed a significant increase in R wave voltage whereas horizontal and dextrorotated ones showed a diminished amplitude (p less than 0.01) independent of body weight. There was no relation between R wave voltage and body surface. We conclude that: Body mass is not an important modifier of R wave amplitude in thin, normal and light overweight subjects. Heart position may induce significant variation of R wave voltage according to the degree of the projection of the left ventricular electric field to the anterior thoracic surface.
尽管已有报道称许多因素会改变心电图的R波振幅，但未经任何考量的直接测量一直是首选方法，这导致了有争议的结果。我们推测体重指数和心脏位置是R波振幅的主要调节因素。为验证这一假设，我们对80名正常受试者进行了标准心电图研究，分析了心电图与体质变量的相关性，并根据心电图心脏位置进行了分析。R波振幅与体重呈非显著负相关，但重度超重受试者除外（p<0.05）。按心脏位置分析时，左旋及S1、S2、S3心脏的R波电压显著升高，而水平及右旋心脏的振幅降低（p<0.01），且与体重无关。R波电压与体表无相关性。我们得出结论：在体型瘦、正常及轻度超重的受试者中，体重并非R波振幅的重要调节因素。心脏位置可能会根据左心室电场向前胸表面的投射程度，导致R波电压发生显著变化。
