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Transient U wave inversion during variant angina.

T Matsuguchi, Y Koiwaya, O Nakagaki

    American Heart Journal
    |October 1, 1984
    PubMed
    Summary
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    Transient U wave inversion is common during variant angina with anterolateral ischemia but not inferoposterior ischemia. This ECG finding is linked to myocardial ischemia, not blood pressure changes.

    Area of Science:

    • Cardiology
    • Electrophysiology

    Background:

    • Variant angina is characterized by coronary artery spasms causing myocardial ischemia.
    • Electrocardiogram (ECG) changes, including ST-segment elevation, are typical during anginal attacks.
    • The significance of transient U wave inversion during variant angina requires further investigation.

    Purpose of the Study:

    • To investigate the prevalence and clinical significance of transient U wave inversion in patients with variant angina.
    • To determine the association between U wave inversion and the location of myocardial ischemia during variant angina.
    • To differentiate the cause of U wave inversion, distinguishing between myocardial ischemia and changes in blood pressure.

    Main Methods:

    • Studied 43 patients diagnosed with variant angina.

    Related Experiment Videos

  • Categorized patients into two groups based on ECG findings during angina: anterolateral ST elevation (Group A) and inferoposterior ST elevation (Group B).
  • Assessed U wave inversion during spontaneous angina and performed treadmill exercise testing in a subset of patients to evaluate the role of blood pressure.

    • Main Results:

    • Transient U wave inversion occurred in 66.7% of Group A patients (anterolateral ischemia) but in none of Group B patients (inferoposterior ischemia) during anginal attacks.
    • U wave inversion was not present on resting ECGs in the absence of angina.
    • Treadmill exercise testing in 12 patients did not induce angina or U wave inversion despite elevated systolic blood pressure, suggesting ischemia, not hypertension, as the cause.

    Conclusions:

    • Transient U wave inversion is a frequent finding associated with anterolateral myocardial ischemia in variant angina.
    • U wave inversion in variant angina is likely caused by myocardial ischemia rather than a transient rise in systolic blood pressure.
    • The presence and characteristics of U wave inversion may help localize the ischemic region in variant angina.