Ethnic differences in electrocardiographic amplitude measurements

Ishak A. Mansi, Ira S. Nash

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: There is controversy regarding ethnic differences in electrocardiographic (ECG) patterns because of potentially confounding socioeconomic, nutritional, environmental and occupational factors. Methods: We reviewed the first 1000 medical files of a multi-ethnic community, where all individuals shared similar living conditions. Only healthy adults age 15 to 60 years were included. Wave amplitudes were measured manually from the standard 12 lead-ECG. Minnesota coding was used. Results: ECGs from 597 subjects were included in the study: 350 Saudi Arabians, 95 Indians, 39 Jordanians, 17 Sri-Lankans, 39 Filipinos, and 57 Caucasians; 349 were men. The mean±SD of Sokolow-Lyon voltage (SLV) in men was significantly different among ethnic groups (2.9 ± 0.86, 2.64 ± 0.79, 2.73 ± 0.72, 3.23 ± 0.61, 2.94 ± 0.6, 2.58 ± 0.79 mV; P=0.0006, for Saudis, Indians, Jordanians, Filipinos, Sri-Lankans, and Caucasians, respectively). SLV was similar among ethnic groups in women. The prevalence of early transition patterns was also different among ethnic groups in men but not women (15.8%, 34.6%, 17.9%, 21.7%, 35.3%, 26.8% in Saudi, Indian, Jordanian, Filipino, Sri-Lankan, and Caucasian men, respectively, P=0.037). T wave amplitude was significantly different among ethnic groups in selected leads. Conclusions: ECG wave amplitude differs with ethnic origin even when other factors are similar. Using SLV of 3.5 mV as a criterion may overestimate the incidence of left ventricular hypertrophy in some ethnic groups. The pattern of high R wave in lead V1 is common in healthy adults in certain ethnic groups. T wave height differs with ethnic origin and sex.

Original languageEnglish (US)
Pages (from-to)459-464
Number of pages6
JournalAnnals of Saudi Medicine
Issue number6
StatePublished - 2004


  • Electrocardiography
  • Ethnicity
  • Left ventricular hypertrophy
  • T wave

ASJC Scopus subject areas

  • Medicine(all)


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