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Clinical Investigations: CARDIOLOGY |

Effect of Weight Loss on the ECG of Normotensive Morbidly Obese Patients*

Martin A. Alpert, MD, FCCP; Boyd E. Terry, MD; Charles R. Hamm, MD; T. Michael Fan, MD, PhD; Michael V. Cohen, MD; Clara V. Massey, MD; Jack A. Painter, MD
Author and Funding Information

*From the Division of Cardiology (Drs. Alpert, Fan, Cohen, Massey, and Painter), and Department of Pediatrics (Dr, Hamm), University of South Alabama College of Medicine, Mobile, AL; and the Department of Surgery (Dr. Terry), University of Missouri School of Medicine, Columbia, MO.

Correspondence to: Martin A. Alpert, MD, FCCP, Suite 10C, University of South Alabama Medical Center, 2451 Fillingim St, Mobile, AL 36617



Chest. 2001;119(2):507-510. doi:10.1378/chest.119.2.507
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Background: Morbid obesity produces a variety of ECG alterations, including leftward shifts of the P-wave, QRS, and T-wave axes; disproportionately high frequencies of low QRS voltage; left ventricular hypertrophy and left atrial abnormality; and a high frequency of T-wave flattening in the inferior and lateral leads. This study was designed to assess the effects of substantial weight loss on the ECG in morbid obesity.

Methods: We performed a resting 12-lead ECG on 60 normotensive patients (48 women and 12 men; mean ± SD age, 37 ± 7 years), whose body weight was twice their ideal body weight prior to and at the time of maximum weight loss after bariatric surgery.

Results: Mean weight decreased from 136 ± 7 to 85 ± 3 kg. Weight loss produced significant decreases in the frequencies of low QRS voltage; Romhilt-Estes point score ≥ 5 points; SV1 + RV5 or V6 > 35 mm; RV5 or V6 > 26 mm; RaVL > 11 mm; RaVL≥ 7.5 mm; SaVR > 14 mm; P-terminal force more negative than− 0.04 mm·s in lead V1; and T-wave flattening in the inferior, lateral, and inferolateral leads. Weight loss significantly shifted the mean P-wave, QRS, T-wave axes rightward, and significantly reduced mean RaVL and mean SaVR voltage.

Conclusion: Substantial weight loss is capable of reversing many of the ECG alterations associated with morbid obesity.


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