The significance of inversion U wave during exercise ECG

Objective & Hypothesis:AIM: We planned this study to investigate whether the inversion of U wave observed in precordial lead of exercise ECG enhance the specificity of exercise stress test in non-invasive determination of the left anterior descending coronary artery disease.

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Key Findings & Data:The patients were divided into two groups; those with U wave inversion observed in exercise ECG (group 1) and those without this sign (group 2).

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Conclusion & Impact:This increase was obvious in women

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Elektrokardiyografi · Koroner hastalık · Koroner damarlar

Abstract

AIM: We planned this study to investigate whether the inversion of U wave observed in precordial lead of exercise ECG enhance the specificity of exercise stress test in non-invasive determination of the left anterior descending coronary artery disease. MATERIAL AND METHODS: One hundred twenty seven patients applied to cardiology out-patients clinic with chest pain were included in this study. The patients were divided into two groups; those with U wave inversion observed in exercise ECG (group 1) and those without this sign (group 2). The exercise stress test, coronary angiography and left ventriculography were applied to all patients. The ST segment and U wave analysis were performed in exercise stress test. Duration of exercise and METS values were calculated. After performing left ventriculography, ejection fraction was determined. The results of two groups were compared and p<0.05 was considered to be statistically significant. RESULTS: The heart rate at rest (p<0.001), the heart rate occurred maximum ST depression (p<0.01) and ejection fraction (p<0.01) were found to be lower in group 1, whereas the ST segment depression was higher (p<0.01) and the number of patients with left anterior coronary artery disease (p<0.001) and with three vessel disease (p<0.05) were compared to group 2. CONCLUSION: The inversion of U wave observed in precordial lead of exercise ECG enhance the specificity of exercise stress test in non-invasive determination of the left anterior descending coronary artery disease. This increase was obvious in women

Özet

AMAÇ: Bu çalışmayı egzersiz EKG'de görülen U dalgası inversiyonunun sol ön inen koroner arter hastalığının noninvazif olarak belirlenmesinde egzersiz stres testinin özgüllüğünü arttırıp arttırmadığını araştırmak için planladık. GEREÇ VE YÖNTEM: Kardiyoloji po likliniğine göğüs ağrısıyla gelen 127 hasta çalışmaya alındı. Hastalar, egzersiz EKG'de U dalgası inversiyonu olan (grup 1) ve olmayan (grup 2) olarak iki gruba ayrıldı. Tüm hastalara egzersiz stres testi, koroner anjiyografi ve sol ventrikülografi uygulandı. Egzersiz stres testinde ST segment ve U dalgası analizi yapıldı, egzersiz süreleri ve METS değerleri hesaplandı. Sol ventrikülografiden sonra ejeksiyon fraksiyonu hesaplandı. İki grup değerleri arasında karşılaştırma yapıldı ve p<0.05 olduğunda anlamlı kabul edildi. BULGULAR: Grup 1'de istirahat kalp hızı daha düşük (p<0.001), ST segment çökmesi daha fazla (p<0.01), maksimum ST çökme hızı daha düşük (p<0.01), ejeksiyon fraksiyonu daha düşük (p<0.01), sol ön inen koroner arter hastası (p<0.001) ve 3 damar hastası daha fazla (p<0.05) idi. SONUÇ: Sol ön inen koroner arter hastalığının belirlenmesinde egzersiz EKG'de görülen U dalgası inversiyonu, ST segment çökmesine göre testin özgüllüğünü arttırır ve bu artış kadınlarda daha da belirgindir.

Keywords

Elektrokardiyografi Koroner hastalık Koroner damarlar Göğüs ağrısı Kalp debisi Egzersiz testi Koroner anjiyografi Strok volümü Electrocardiography Coronary Disease Coronary Vessels Chest Pain Cardiac Output Exercise Test Coronary Angiography Stroke Volume

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Cite This Article

ALTUNKESER, B. B., ÖZDEMİR, K., TEMİZHAN, A., GÖK, H. (2001). The significance of inversion U wave during exercise ECG. MN Kardiyoloji, Cilt: 8 - Sayı: 3, 194–197. https://ajindex.com/articles/297855

References (5)

Gerson MC, Phillips JF, Morris SN, McHenry PL. Exercise-induced J-wave inversion as a marker of stenosis of the left anterior descending coronary artery. Circulation 1979; 60:1014-20.
Wiwa K, Murakami T, Kambara H, Kawai C. U-wave inversion during attacks of variant angina. Br Heart J 1983; 50:378-82.
Vliwa K, Miyagi Y, Fujita M, et al. Transient terminal U wave nversion as a more specific for miyocardial ischemia. Am Heart J 1993:125:981-6.
Hamura A, Watanabe T, Nagase K, et al. Significance of negative U vaves in the precordial leads during anterior wall acute miyocardial nfarction. Am J Cardiol 1997; 79:897-900.
Shaw L, Miller D, Roniies J, et al. Gender differences in the ıoninvasive evaluation and management of patients with suspected coronary artery disease. Ann Intern Med 1994; 120:559-66. inversiyonunun önemi sayfa 4 1.Morise AP, Diamond GA. Comparison of the sensitivity and specificity of exercise electrocardioğraphy in biased and unbiased populations of men and women. Am Heart J 1995; 130:741-7. 2.Gibbons RJ, Balady GJ, Beasley JW, et al. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol 1997; 30:260-315. 3.Clark P, Glasser SP, Lyman GH, et al. Relation of results of exercise stress tests in young women to phases of the menstrual cycle. Am J Cardiol 1988; 61:197-202 4.Bruce RA, McDonough JR. Stress testing for cardiovascular disease. Bull N Y Acad Med 1969; 45:1288-1294. 5.AHA Committee Report. A reporting system on patients for coronary artery disease. Circulation 1975; 51(suppl):7-40. 6.Palmer JH. U wave inversion. Br Heart J 1948; 10:247-51. 7.Gerson Me, McHenry PL. Resting U wave inversion as a marker of stenosis of the left anterior descending coronary artery. Am J Med 1980;69:545-50. 8.Kishida H, Cole JS, Surawicz B. Negative U wave: a highly specific but poorly understood sign of heart disease. Am J Cardiol 1982; 49:2030-6. 9.Matsuguchi T, Koiwaya Y, Nakagaki O, Takeshita A, Nakamura M. Transient U wave inversion during variant angina. Am Heart J 1984; 108:899-904. 10.Choo MH, Gibson DG. U waves in ventricular hypertrophy: possible demonstration of mechanoelectrical feedback. Br Heart J 1986; 55:428-33. 11.Lepeschkin E. Physiologic basis of the U wave. In: Schlant RC, Hurst JW, eds. Advances in electrocardioğraphy. New York: Grune andStratton, 1972; 431-7. 12.Watanabe Y. Purkinje repolarization as a possible cause of the U wave in e