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        <identifier>oai:figshare.com:article/33981406</identifier>
        <datestamp>2026-09-24T10:56:21Z</datestamp>
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          <dc:title>Supplemental Material for: Empirical Classification of T-Wave Inversion Patterns as Lower-risk or Higher-risk in Black Adults: A Wall-Based Prevalence and Outcomes Analysis from the Jackson Heart Study</dc:title>
          <dc:creator>figshare admin karger (2628495)</dc:creator>
          <dc:creator>José Nunes de Alencar (25103480)</dc:creator>
          <dc:subject>Medicine</dc:subject>
          <dc:subject>Medicine</dc:subject>
          <dc:description>&lt;p dir="ltr"&gt;Introduction T-wave inversion (TWI) in Black adults is interpreted through criteria derived from White populations or competitive athletes, never tested with outcomes data in non-athletic community adults. To classify TWI patterns as lower-risk or higher-risk using lead-specific outcomes thresholds, and derive a race-specific reference from a healthy subcohort. &lt;br&gt;Methods We analyzed 3,514 Black adults from the Jackson Heart Study Exam 1 (2000–2004). A wall-based system classified higher-risk TWI as Tnet &lt;−100 µV in lateral, anterior, or inferior leads; benign patterns were isolated V1 and isolated lead III. A healthy subcohort (N=668) free of hypertension, diabetes, obesity, CKD, coronary disease, heart failure, and left ventricular hypertrophy (LVH) ECG criteria served as reference. Logistic regression assessed cardiometabolic associations; Cox models assessed incident outcomes over median 11.8-year follow-up. &lt;br&gt;Results Higher-risk TWI was present in 262 (7.5%; healthy: 3.0%); lower-risk patterns in 685 (19.5%). Higher-risk TWI independently predicted Hard coronary heart disease (CHD), with an adjusted hazard ratio of 2.47 (95% CI 1.51–4.04), and was associated with hypertension (OR 1.98) and ECG-LVH (OR 3.98). Benign V1 showed inverse associations with diabetes (OR 0.48) and LVH (OR 0.36), with 1 Hard CHD event during follow-up; the higher-risk effect was homogeneous across health strata (P-interaction=0.455). The classic V1–V2–V3 juvenile pattern occurred in 1 of 3,514; V3 inversion carried Hard CHD HR 3.49. &lt;br&gt;Conclusion Anterior T-wave inversion in V2, V3, or V4 in non-athletic Black community-dwelling adults is not necessarily a benign signal and should not be assumed to represent a persistent juvenile variant. These data provide the first outcomes-anchored ECG reference for this population.&lt;/p&gt;</dc:description>
          <dc:date>2026-09-24T10:56:21Z</dc:date>
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          <dc:identifier>10.6084/m9.figshare.33981406.v1</dc:identifier>
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          <dc:rights>CC BY 4.0</dc:rights>
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