Negative T wave in chest lead V1: relation to sex and future cardiovascular risk factors

OBJECTIVES
The significance of T-wave negativity in lead V1 in adults and its relationship with cardiovascular risk factors have not been clarified. This study was designed to determine the prevalence of negative T waves in chest lead V1 in an adult cohort.

STUDY DESIGN
The study included 508 adults (278 males, mean age 51.5±9.7 years; 230 females, mean age 51.2±10.0 years) enrolled in the longitudinal Turkish Adult Risk Factor survey from all geographical regions of Turkey, whose prospective data on the prevalence of coronary heart disease and its risk factors were available for comparative assessment of T-wave groups. Associations of negative T waves were sought in relation to age, sex, cardiovascular risk factors, and coronary heart disease.

RESULTS
The prevalence of T-wave negativity in women was significantly higher than that of men (38.3% vs 7.2%; p<0.001). No age-related differences were found between the two sexes with respect to the presence or absence of negative T waves (p>0.05). Cardiovascular risk factors and cardiometabolic conditions did not differ among men with respect to the T-wave pattern. However, women presenting negative T waves in lead V1 had significantly lower systolic blood pressure (p=0.007) and HDL-cholesterol (p=0.034) values, and a higher incidence of type 2 diabetes (p=0.048) than women with positive T waves.

CONCLUSION
No convincing explanation could be offered for the significantly higher female predilection for the presence of negative T-waves in lead V1. Negative T waves in lead V1 were not associated with adverse cardiometabolic risks.