Association between negative T waves in lead V1 and delayed patent ductus arteriosus closure in preterm neonates.

Abstract

Objectives: The aim of this study is to determine whether the presence of a negative T wave in lead V1 within 15 h after birth is associated with delayed closure of patent ductus arteriosus (PDA) in preterm neonates within the first week of life.

Methods: A retrospective cohort study was conducted involving neonates with a gestational age between 270/70/7 and 411/71/7 weeks who were less than 15 h old and had documented T-wave morphology in lead V1, with PDA confirmed by echocardiography. Neonates with asphyxia, congenital infections, structural heart defects, major malformations, or clinical sepsis were excluded. The cohort was categorized into two groups based on T-wave morphology: Group A (n = 200; normal T wave) and Group B (n = 29; negative T wave). Echocardiographic assessments of PDA closure were performed at different time intervals (days 0-2, 2-5, and 5-7).

Results: A total of 229 neonates were included, with a mean gestational age of 35.5 ± 3.23 weeks and a mean birth weight of 2.54 ± 0.78 kg. PDA was diagnosed in 54 neonates (23.6%). Negative T waves in lead V1 were observed in 29 neonates (12.7%) within 15 h after birth, of whom 15 (51.7%) had PDA. The median time to PDA closure differed significantly between Groups A and B, with closure occurring at 2 (0-2), 5 (2-5), and 7 (5-7) days, respectively (log-rank test, p < 0.01). Cox proportional hazards regression analysis identified the presence of a negative T wave in lead V1 as an independent predictor of PDA closure time (adjusted hazard ratio, 0.559; 95% confidence interval: 0.318-0.984).

Conclusion: The presence of a negative T wave in lead V1 within 15 h after birth independently predicted a higher likelihood of persistent PDA at day 7 in preterm neonates.