{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:57:19Z","timestamp":1787500639172,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,4,2]],"date-time":"2015-04-02T00:00:00Z","timestamp":1427932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:p>\n                    The cardiac axis in a structurally normal heart is influenced by a number of factors. We investigated the anatomical and electrical cardiac axes in middle\u2010aged individuals without structural heart disease and compared this with age\u2010matched obese and older individuals without structural heart disease. A retrospective study of controls included those between 30 and 60 years old with a normal body mass index (BMI), who were then compared with obese individuals between 30 and 60 years old and with individuals more than 60 years old with a normal BMI. The anatomical cardiac axis was determined along the long axis by cardiac computed tomography (CT) and correlated with the electrical cardiac axis on a surface electrocardiogram (ECG) in the frontal plane. A total of 124 patients were included. In the controls (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200959), the mean CT axis was 38.1\u00b0\u2009\u00b1\u20097.8\u00b0 whilst the mean ECG axis was 51.8\u00b0\u2009\u00b1\u200926.6\u00b0, Pearson\n                    <jats:italic>r<\/jats:italic>\n                    value 0.12 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.365). In the obese (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200936), the mean CT axis was 25.1\u00b0\u2009\u00b1\u20096.2\u00b0 whilst the mean ECG axis was 20.1\u00b0\u2009\u00b1\u200923.9\u00b0, Pearson\n                    <jats:italic>r<\/jats:italic>\n                    value 0.05 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.808). In the older group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200929), the mean CT axis was 34.4\u00b0\u2009\u00b1\u20099.1\u00b0 whilst the mean ECG axis was 34.4\u00b0\u2009\u00b1\u200930.3\u00b0, Pearson\n                    <jats:italic>r<\/jats:italic>\n                    value 0.26 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.209). Obese individuals have a more leftward rotation of both axes than age\u2010matched normals (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.0001), which could be secondary to elevation of the diaphragm. Older individuals have a more leftward rotation only of their electrical cardiac axis (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.01), which could be a normal variant or reflect underlying conduction disturbances in this age group. Clin. Anat. 28:487\u2013493, 2015. \u00a9 2015 Wiley Periodicals, Inc.\n                  <\/jats:p>","DOI":"10.1002\/ca.22532","type":"journal-article","created":{"date-parts":[[2015,4,2]],"date-time":"2015-04-02T18:08:02Z","timestamp":1427998082000},"page":"487-493","source":"Crossref","is-referenced-by-count":9,"title":["Computed tomography\u2010guided in vivo cardiac orientation and correlation with\n                    <scp>ECG<\/scp>\n                    in individuals without structural heart disease and in age\u2010matched obese and older individuals"],"prefix":"10.1002","volume":"28","author":[{"given":"Gnalini","family":"Sathananthan","sequence":"first","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"},{"name":"Department of Cardiology Auckland Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunjan","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Prince of Wales Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simmi","family":"Zahid","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Byth","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Chik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Prince of Wales Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinda","family":"Thiagalingam","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20741"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10517-005-0435-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(81)90081-3"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.21.6.1160"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-0736(68)80014-7"},{"key":"e_1_2_6_7_1","volume-title":"Clinical vectorcardiography and electrocardiography","author":"Cooksey 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