Meng Hong, Wang Jiangya, Jiang Xingxing, Tian Lei, Liu Tingting, Ye Yuquan
Department of Ultrasound Medicine, Hebei Medical University, No.348 of Heping west Road, Shijiazhuang, 050051, Hebei, China.
Heart Center, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
J Cardiothorac Surg. 2025 May 27;20(1):240. doi: 10.1186/s13019-025-03494-8.
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.
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).
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).
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.
本研究旨在确定出生后15小时内V1导联出现T波倒置是否与早产新生儿出生后第一周内动脉导管未闭（PDA）闭合延迟有关。
进行一项回顾性队列研究，纳入胎龄在27⁰⁰/⁷至41⁰¹/⁷周之间、出生小于15小时且有V1导联T波形态记录、经超声心动图确诊为PDA的新生儿。排除有窒息、先天性感染、结构性心脏缺陷、重大畸形或临床败血症的新生儿。根据T波形态将队列分为两组：A组（n = 200；T波正常）和B组（n = 29；T波倒置）。在不同时间间隔（第0 - 2天、2 - 5天和5 - 7天）对PDA闭合情况进行超声心动图评估。
共纳入229例新生儿，平均胎龄为35.5 ± 3.23周，平均出生体重为2.54 ± 0.78 kg。54例新生儿（23.6%）诊断为PDA。29例新生儿（12.7%）在出生后15小时内V1导联出现T波倒置，其中15例（51.7%）有PDA。A组和B组PDA闭合的中位时间有显著差异，分别在第2天（0 - 2天）、第5天（2 - 5天）和第7天（5 - 7天）闭合（对数秩检验，p < 0.01）。Cox比例风险回归分析确定V1导联出现T波倒置是PDA闭合时间的独立预测因素（调整后的风险比，0.559；95%置信区间：0.318 - 0.984）。
出生后15小时内V1导联出现T波倒置可独立预测早产新生儿在第7天持续存在PDA的可能性更高。
