Daralammouri Yunis, Azamtta Murad, Hamayel Hamza, Adas Amro, Sawalmeh Osama, Ismail Yahia, Zyoud Saed H
Department of Cardiology, An-Najah National University Hospital, Nablus, State of Palestine.
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, State of Palestine.
Cardiol Res Pract. 2021 Feb 11;2021:6653061. doi: 10.1155/2021/6653061. eCollection 2021.
The standard electrocardiogram (ECG) is commonly performed in the supine posture. It may be difficult to report ECG in a supine posture for those who are unable to adopt the supine posture because of certain circumstances such as acute respiratory distress syndrome-patients who are placed in a prone position for long periods to improve oxygenation. Few data are available on the impact of the prone position on the ECG recording with electrodes on the posterior chest. Examining and analyzing the type and extent of changes observed in the prone ECG in healthy adults have become vitally valuable.
A cross-sectional observational study enrolled forty healthy adults (24 males and 16 females) aged between 18 and 40 years. The ECG was performed in two different body positions, supine and prone. Influence of prone position on the heart rate, mean QRS axis, amplitude, morphology, duration, mean wave axis and polarity, mean wave axis, PR, and mean QTc duration was evaluated.
The mean heart rate was higher in the prone position (73.2 ± 12.4 bpm) compared with the supine position (69.5 ± 11.5 bpm, = 0.03). The QRS duration decreased considerably from supine (92.8 ± 12.6 ms) to prone (84.9 ± 11.9 ms, < 0.001). The mean QRS axis moved to the left in the prone posture (40.5° ± 32°) relative to the supine (49° ± 28°, =0.015). The QRS amplitude in the precordial leads was significantly decreased from supine (7.42 ± 3.1 mV) to prone (3.68 ± 1.7 mV, < 0.001). In addition, changes in the QRS morphology in leads V1-V3 with the appearance of new waves were noted. A notable variation in the mean corrected QT (QTc) period with decrease in duration in prone posture ECG (385 ± 64.8) relative to supine (406 ± 18.8, =0.05).
Prone position ECG resulted in significant changes in healthy adults that should be aware of this as this can affect diagnosis and management strategies. Further studies are needed to investigate the impact of prone position on ECG recording in patients with cardiovascular diseases.
标准心电图（ECG）通常在仰卧位进行。对于因某些情况（如急性呼吸窘迫综合征）而无法采取仰卧位的患者（这些患者长时间处于俯卧位以改善氧合），以仰卧位报告心电图可能会有困难。关于俯卧位对后胸部电极心电图记录的影响，现有数据很少。研究和分析健康成年人俯卧位心电图中观察到的变化类型和程度变得至关重要。
一项横断面观察性研究纳入了40名年龄在18至40岁之间的健康成年人（24名男性和16名女性）。分别在仰卧位和俯卧位两种不同体位下进行心电图检查。评估俯卧位对心率、平均QRS电轴、振幅、形态、时限、平均P波电轴和极性、平均T波电轴、PR间期以及平均QTc间期的影响。
与仰卧位（69.5±11.5次/分钟，P = 0.03）相比，俯卧位时平均心率更高（73.2±12.4次/分钟）。QRS时限从仰卧位（92.8±12.6毫秒）到俯卧位（84.9±11.9毫秒）显著缩短（P < 0.001）。相对于仰卧位（49°±28°，P = 0.015），俯卧位时平均QRS电轴向左移动（40.5°±32°）。胸前导联的QRS振幅从仰卧位（7.42±3.1毫伏）到俯卧位（3.68±1.7毫伏）显著降低（P < 0.001）。此外，还注意到V1 - V3导联QRS形态的变化，出现了新的Q波。与仰卧位心电图（406±18.8）相比，俯卧位心电图的平均校正QT（QTc）间期显著缩短（385±64.8，P = 0.05）。
俯卧位心电图在健康成年人中导致了显著变化，应予以关注，因为这可能影响诊断和管理策略。需要进一步研究来调查俯卧位对心血管疾病患者心电图记录的影响。
