The electrocardiogram (ECG) is routinely used in cardiology, though its
interpretation is confounded by anatomical variability. A novel, automated
computational pipeline enables quantification of torso-ventricular anatomy
metrics from magnetic resonance imaging, and comparison to ECG characteristics.
Sex and myocardial infarction differences are investigated based on 1051
healthy and 425 post-MI subjects from UK Biobank. Smaller ventricles in females
explain ~50% of shorter QRS durations than in males, and contribute to lower
STJ amplitudes in females (also due to more superior and posterior position).
In females, torso-ventricular anatomy, particularly from larger BMI, is a
stronger modulator of T wave amplitude reductions and left-deviated R axis
angles in post-MI than in males. Thus, female MI phenotype is less reflective
of pathology, and baseline STJ amplitudes and QRS durations are further from
clinical thresholds. Therefore, quantification of anatomical sex-differences
and impact on ECG in health and disease is critical to avoid clinical sex-bias.

电心图 (ECG) 在心脏学中被常规使用，但其解读受解剖变异的干扰。一项新颖的自动化计算流程可通过磁共振成像对胸腔心室解剖度量进行量化，并与 ECG 特征进行比较。基于来自英国生物库的 1051 名健康人和 425 名心肌梗死后患者，探索性别和心肌梗死差异。女性较小的心室解释了 QRS 间期较男性短约 50％，并导致女性 STJ 振幅较低 (也由于位置较上颈和后部)；在女性中，来自较大体重指数的胸腔心室解剖度量尤其是对后心肌梗死中 T 波振幅降低和偏左 R 轴角度的调节较男性更强烈。因此，定量解剖性别差异及其对健康和疾病中 ECG 的影响对于避免临床性别偏见至关重要。