Original title: Anatomical basis of sex differences in human post-myocardial infarction ECG phenotypes identified by novel automated torso-cardiac 3D reconstruction
Authors: Hannah J. Smith, Blanca Rodriguez, Yuling Sang, Marcel Beetz, Robin Choudhury, Vicente Grau, Abhirup Banerjee
In this article, researchers discuss how the interpretation of electrocardiograms (ECGs) is impacted by anatomical variability. They propose a new automated computational pipeline that uses magnetic resonance imaging to assess torso-ventricular anatomy and compare it to ECG characteristics. To investigate sex and myocardial infarction differences, the researchers analyzed data from 1051 healthy subjects and 425 post-MI subjects from the UK Biobank.
The results showed that females have smaller ventricles, which explains why they have shorter QRS durations compared to males. Additionally, females also have lower STJ amplitudes due to the more superior and posterior position of their ventricles. The study also found that in females, torso-ventricular anatomy, particularly in those with larger body mass index, has a stronger influence on T wave amplitude reductions and left-deviated R axis angles in post-MI cases.
These findings suggest that the phenotype of myocardial infarction in females is less reflective of pathology compared to males. It also indicates that baseline STJ amplitudes and QRS durations in females are further from clinical thresholds. Understanding these anatomical sex differences and their impact on ECG readings in both healthy individuals and those with disease is crucial to avoid clinical sex-bias.
Original article: https://arxiv.org/abs/2312.13976