Anatomical basis of sex differences in human post-myocardial infarction ECG phenotypes identified by novel automated torso-cardiac 3D reconstruction
CoRR(2023)
摘要
The electrocardiogram (ECG) is routinely used in cardiology, though its
interpretation is confounded by anatomical variability. A novel, automated
computational pipeline enables quantification of torso-ventricular anatomy
metrics from magnetic resonance imaging, and comparison to ECG characteristics.
Sex and myocardial infarction differences are investigated based on 1051
healthy and 425 post-MI subjects from UK Biobank. Smaller ventricles in females
explain ~50% of shorter QRS durations than in males, and contribute to lower
STJ amplitudes in females (also due to more superior and posterior position).
In females, torso-ventricular anatomy, particularly from larger BMI, is a
stronger modulator of T wave amplitude reductions and left-deviated R axis
angles in post-MI than in males. Thus, female MI phenotype is less reflective
of pathology, and baseline STJ amplitudes and QRS durations are further from
clinical thresholds. Therefore, quantification of anatomical sex-differences
and impact on ECG in health and disease is critical to avoid clinical sex-bias.
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