Abstract 12856: Electrocardiographic T Wave Inversion and Cardiac Structure and Function

Abstract

Background: Electrocardiographic T wave inversion (TWI) has been associated with incident heart failure (HF) in Black Americans without known coronary heart disease (CHD). The aim of this study was to investigate the relationship between TWI and left ventricular (LV) structure and function to evaluate cardiac changes that may precede symptomatic disease among Black Americans. Methods: Among 4134 Black American participants in the Jackson Heart Study without prevalent HF or CHD at baseline. We defined TWI as having negative T wave amplitudes in each lead of the 12-lead electrocardiogram. Outcomes of interest included echocardiographic LV structure (LV mass index, LVMI, LV diastolic dimension, LVDd and relative wall thickness, RWT) and LV function (LV ejection fraction, LVEF). We investigated the associations between TWI and LV structure and function using multiple linear regression analysis. For participants with missing values in any covariate of interest, values were imputed using multiple imputation by chained equations. Results: In this cohort with median age 55 years and 65% women. The depth of the inverted T wave in leads I and aVL were positively associated with RWT (Figure). The depth of the inverted T waves in leads II, III, and aVF were associated with LVDd. The depth of the inverted T waves in all the leads except V1 and V2 were associated with LVMI, while T wave inversions in only aVF were associated with LVEF. Conclusion: The depth of inverted T waves in leads I and aVL (which were associated with incident HF with preserved EF) were associated with LV concentricity while T wave amplitudes in leads II, III, and aVF (which were associated with incident HF reduced EF) were associated with LV eccentricity. Simple electrocardiographic information may be useful for identifying patients at risk of HF (stage B/pre HF).