R-wave Amplitude in Lead II of an Electrocardiograph Correlates with Central Hypovolemia in Human Beings

Abstract

Objectives: Previous animal and human experiments have suggested that reduction in central blood volume either increases or decreases the amplitude of R waves in various electrocardiograph (ECG) leads depending on underlying pathophysiology. In this investigation, we used graded central hypovolemia in adult volunteer subjects to test the hypothesis that moderate reductions in central blood volume increases R-wave amplitude in lead II of an ECG. Methods: A four-lead ECG tracing, heart rate (HR), estimated stroke volume (SV), systolic blood pressure, diastolic blood pressure, and mean arterial pressure were measured during baseline supine rest and during progressive reductions of central blood volume to an estimated volume loss of greater than 1,000 mL with application of lower-body negative pressure (LBNP) in 13 healthy human volunteer subjects. Results: Lower-body negative pressure resulted in a significant progressive reduction in central blood volume, as indicated by a maximal decrease of 65% in SV and maximal elevation of 56% in HR from baseline to 60 mm Hg LBNP. R-wave amplitude increased (p less than 0.0001) linearly with progressive LBNP. The amalgamated correlation (R2) between average stroke volume and average R-wave amplitude at each LBNP stage was -0.989. Conclusions: These results support our hypothesis that reduction of central blood volume in human beings is associated with increased R-wave amplification in lead II of an ECG.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2006
Accession Number
ADA628043

Entities

People

  • David A. Ludwig
  • John B Holcomb
  • John G. McManus
  • Victor A Convertino
  • William H. Cooke

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Amplitude
  • Blood
  • Blood Volume
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System
  • Data Analysis
  • Electrocardiography
  • Health Services
  • Heart
  • Heart Diseases
  • Heart Rate
  • Hemorrhage
  • Hemorrhagic Shock
  • Hospitals
  • Hypovolemia
  • Measurement
  • Medical Personnel

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology