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Effects of age, sex, and race on ECG interval measurements
P W Macfarlane1, S C McLaughlin, B Devine
1Department of Medical Cardiology, University of Glasgow, Royal Infirmary, Scotland.
Insights
Age, sex, and race impact electrocardiogram (ECG) measurements. Pediatric QRS duration increases with age, while adult men show longer QRS duration than women.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Clinical Electrophysiology
Background:
- Electrocardiogram (ECG) parameters vary across demographic groups.
- Understanding these variations is crucial for accurate interpretation of cardiac health.
- Previous studies have suggested potential influences of age, sex, and race on ECG findings.
Purpose of the Study:
- To investigate the effects of age, sex, and race on standard and signal-averaged ECG measurements.
- To establish normative ECG data across different pediatric and adult populations.
- To identify clinically significant demographic variations in ECG intervals.
Main Methods:
- Analysis of ECGs from three distinct populations: pediatric (n=1,782), adult white (n=1,555), and adult Chinese (n=503).
- Standardized computer processing of all ECGs to derive measurements like QRS duration, heart rate, and QT dispersion.
- Inclusion of signal-averaged ECGs for a subgroup of white adults (n=195).
Main Results:
- A linear increase in QRS duration was observed with age in the pediatric group from 1 year to adolescence.
- Adult men exhibited significantly longer QRS durations compared to adult women in both standard and signal-averaged ECGs.
- Higher upper limits for normal heart rate were noted in adult women compared to men across both adult cohorts.
Conclusions:
- Age is a significant determinant of QRS duration in pediatric populations.
- Sex-based differences in QRS duration and heart rate norms are evident in adults.
- Observed racial differences in ECG measurements were minimal and not considered clinically significant.
Abstract:
The effects of age, sex, and race on the electrocardiogram (ECG) were studied using three separate populations: a pediatric group of 1,782 neonates, infants, and children, and adult white group of 1,555 individuals, and an adult Chinese cohort of 503 individuals. All ECGs were processed using the same computer program, and various interval measurements were derived, including QRS duration, heart rate, QT dispersion, and selected Q-wave durations. Also, a small subgroup of 195 white subjects had a signal-averaged ECG recorded. In the pediatric group, there was a clear link between age and QRS duration, which increased linearly from about 1 year of age to adolescence. In the adults, the principal differences were an increased QRS duration in men compared with women both in the standard and signal-averaged ECG. Upper limits of normal heart rate also tended to be higher in women than in men in the two adult populations. Small racial differences could be seen in some measurements, but were not thought to be of clinical significance.