title: Effect of weight loss on the ECG of normotensive morbidly obese patients.
abstract: 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 > or = 5 points; SV(1) + RV(5) or V(6) > 35 mm; RV(5) or V(6) > 26 mm; RaVL > 11 mm; RaVL > or = 7.5 mm; SaVR > 14 mm; P-terminal force more negative than - 0.04 mm.s in lead V(1); 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.
  
  
  CONCLUSIONS
  Substantial weight loss is capable of reversing many of the ECG alterations associated with morbid obesity.
authors.affiliation: Division of Cardiology, University of South Alabama College of Medicine, Mobile, AL 36617, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Alpert
authors.forename: B E
authors.initials: BE
authors.lastname: Terry
authors.forename: C R
authors.initials: CR
authors.lastname: Hamm
authors.forename: T M
authors.initials: TM
authors.lastname: Fan
authors.forename: M V
authors.initials: MV
authors.lastname: Cohen
authors.forename: C V
authors.initials: CV
authors.lastname: Massey
authors.forename: J A
authors.initials: JA
authors.lastname: Painter
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology*; D015431:Weight Loss