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Echocardiographic study of U wave inversion in the electrocardiograms of hypertensive patients
N Twidale1, A W Gallagher, A M Tonkin
1Department of Medicine, Flinders Medical Centre, Bedford Park, South Australia.
Insights
U wave inversion is common in hypertension patients, often appearing alone. This electrocardiographic finding may indicate subtle diastolic relaxation abnormalities, not necessarily left ventricular hypertrophy.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Electrophysiology
Background:
- Hypertension is a significant risk factor for cardiovascular disease.
- Electrocardiographic abnormalities are common in hypertensive patients.
- The clinical significance of U wave inversion in hypertension requires further investigation.
Purpose of the Study:
- To determine the prevalence of U wave inversion in adult patients with hypertension.
- To explore the association between U wave inversion and left ventricular hypertrophy (LVH) using echocardiography.
- To investigate potential mechanisms underlying U wave inversion in hypertensive individuals.
Main Methods:
- Prospective evaluation of 58 adult patients diagnosed with hypertension.
- Electrocardiogram (ECG) analysis for U wave inversion and voltage criteria for LVH.
- M-mode echocardiography to assess left ventricular posterior wall thickness and other indices.
Main Results:
- U wave inversion was observed in 34% of hypertensive patients, making it the most frequent ECG abnormality.
- Only 14% of patients met voltage criteria for left ventricular hypertrophy.
- Increased left ventricular posterior wall thickness was detected in 58% of patients, but neither U wave inversion nor voltage criteria strongly predicted this finding.
Conclusions:
- U wave inversion is a prevalent electrocardiographic finding in hypertensive patients, frequently occurring independently.
- The study suggests U wave inversion is not strongly linked to established left ventricular hypertrophy.
- U wave inversion may be associated with subtle abnormalities in diastolic ventricular relaxation in hypertension.
Abstract:
The prevalence of U wave inversion was evaluated in 58 adult patients with hypertension, and a possible mechanism for it was examined using M-mode echocardiographic indices. U wave inversion was the most common electrocardiographic abnormality, occurring in 34% of patients; voltage criteria for left ventricular hypertrophy were present in only 14% of patients, and ventricular strain pattern was not detected in any patient. Nonetheless, on echocardiography left ventricular posterior wall thickness was increased in 58% of patients. However, neither U wave inversion nor conventional voltage criteria for left ventricular hypertrophy was strongly predictive for this finding. The authors conclude that U wave inversion is a frequent finding in patients with hypertension, often occurring alone. Although it does not appear to be closely linked to the presence of left ventricular hypertrophy, it may relate to other, perhaps subtle, abnormalities of diastolic ventricular relaxation.