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

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

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 >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 < 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 amplitude in lead II of an ECG.

Original languageEnglish
Pages (from-to)1003-1010
Number of pages8
JournalAcademic Emergency Medicine
Volume13
Issue number10
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

Fingerprint

Lower Body Negative Pressure
Hypovolemia
Blood Volume
Electrocardiography
Stroke Volume
Blood Pressure
Heart Rate
Volunteers
Healthy Volunteers
Arterial Pressure
Lead

Keywords

  • hemorrhage
  • LBNP
  • R-wave amplitude
  • trauma

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

R-wave Amplitude in Lead II of an Electrocardiograph Correlates with Central Hypovolemia in Human Beings. / McManus, John G.; Convertino, Victor A.; Cooke, William H.; Ludwig, David; Holcomb, John B.

In: Academic Emergency Medicine, Vol. 13, No. 10, 01.10.2006, p. 1003-1010.

Research output: Contribution to journalArticle

McManus, John G. ; Convertino, Victor A. ; Cooke, William H. ; Ludwig, David ; Holcomb, John B. / R-wave Amplitude in Lead II of an Electrocardiograph Correlates with Central Hypovolemia in Human Beings. In: Academic Emergency Medicine. 2006 ; Vol. 13, No. 10. pp. 1003-1010.
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