T-wave inversion and diastolic dysfunction in patients with electrocardiographic left ventricular hypertrophy

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Imaging

Background:

• Animal studies suggest abnormal repolarization contributes to diastolic dysfunction (DD).
• Human data on the relationship between abnormal repolarization and DD is limited.
• Electrocardiogram (ECG) T-wave inversion (TWI) may indicate altered repolarization.

Purpose of the Study:

• To investigate the association between T-wave inversion (TWI) and diastolic dysfunction (DD).
• To assess TWI in patients with ECG-diagnosed left ventricular hypertrophy (LVH) and preserved ejection fraction (EF).

Main Methods:

• 231 patients with ECG-diagnosed LVH and EF ≥ 50% were studied.
• T-wave inversion (TWI) was assessed on specific ECG leads.
• Diastolic dysfunction (DD) was determined by echocardiographic estimation of left atrial pressure.
• Logistic regression analyzed the odds of DD in patients with and without TWI.

Main Results:

• Patients with TWI had a 5.6-fold increased odds of DD after adjusting for multiple risk factors.
• TWI was associated with higher left atrial pressure indicators, including E/e' and left atrial volume index.
• Patients with TWI were more likely to have coronary artery disease and diabetes.

Conclusions:

• T-wave inversion is significantly associated with increased odds of diastolic dysfunction in patients with LVH and preserved EF.
• The findings suggest that TWI, potentially reflecting abnormal repolarization, may be a contributing factor to DD.
• ECG TWI could serve as a non-invasive marker for advanced DD in this patient population.