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Related Experiment Videos

Prominent negative U wave in variant angina pectoris.

H Kishida, F Otsu, K Suzuki

    Japanese Heart Journal
    |November 1, 1985
    PubMed
    Summary

    A prominent negative U wave is a significant indicator of cardiac events, particularly in variant angina pectoris. This ECG finding is more common in variant angina and associated with a less favorable prognosis.

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    Area of Science:

    • Cardiology
    • Electrocardiography
    • Internal Medicine

    Background:

    • The negative U wave is an uncommon ECG finding, occasionally observed during cardiac events like variant angina pectoris.
    • Its clinical significance and prevalence in different types of angina have not been fully elucidated.

    Purpose of the Study:

    • To investigate the clinical profile and diagnostic significance of the negative U wave in patients with variant angina pectoris (VA) and resting angina pectoris (RA).
    • To compare the prevalence of negative U waves between VA and RA patients and correlate findings with ST-segment changes and coronary cinearteriography.

    Main Methods:

    • The study included 80 patients with VA and 33 controls with RA, analyzing their ECGs during spontaneous episodes and exercise testing.
    • ECG findings, including negative U waves and ST-segment deviations, were compared between groups.

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  • Coronary cinearteriography was performed to assess for coronary stenosis.

    • Main Results:

    • A prominent negative U wave was observed in 68.8% of VA patients and 30.3% of RA patients, a statistically significant difference (p < 0.001).
    • Negative U waves predominantly appeared in leads with ST-segment elevation and correlated with ST-segment changes during exercise testing (70% vs. 10.4%).
    • Coronary cinearteriography did not reveal a direct correlation between negative U waves and the presence of stenosis. Patients with negative U waves had a less favorable prognosis, with higher mortality in the RA group.

    Conclusions:

    • The negative U wave is significantly more prevalent in variant angina pectoris compared to resting angina pectoris.
    • While not directly linked to coronary stenosis, the negative U wave is a valuable ECG marker associated with adverse cardiac events and a poorer prognosis.
    • Further research is needed to understand the underlying mechanism of the negative U wave in cardiac ischemia.