Kishida H, Otsu F, Suzuki K, Hata N, Kusama Y, Suzuki T, Nejima J, Saito T, Iida N
Jpn Heart J. 1985 Nov;26(6):885-96. doi: 10.1536/ihj.26.885.
The extremely prominent negative U wave occasionally appears during a cardiac attack in variant angina pectoris. The clinical profile of the negative U wave was therefore studied in 80 patients with variant angina pectoris (VA) and 33 controls with resting angina pectoris (RA). The prominent negative U wave appeared in 55 of the patients with VA (68.8% of patients) and in 10 of the patients with RA (30.3%); thus, there was a significant difference in the appearance of the wave between the 2 groups of patients (p less than 0.001). The leads in which the negative U wave appeared were mostly consistent with those in which the ST segment was elevated. The negative U wave began to appear at about the time when ST-segment elevation began to improve; the wave then gradually became very prominent and then eventually disappeared. The patients with VA and also those with RA on whose ECGs the negative U wave appeared during exercise testing also had negative U waves during spontaneous episodes of angina. An investigation of the frequency of appearance of ST deviation and negative U waves during exercise testing, regardless of the type of angina pectoris, disclosed that the negative U wave appeared in 14 of 20 patients with ST-segment elevation (70% of patients), while the negative U wave appeared in only 52 of 519 patients with either no ST change or ST-segment depression (10.4%); thus, there was a significant difference in the appearance of the negative U wave between these 2 groups (p less than 0.001). Coronary cinearteriography failed to disclose any apparent difference between the appearance of the negative U wave and the presence of stenosis. The prognosis of VA and RA in patients with negative U waves was less favorable compared to those without negative U waves. In particular, we noted that of the 10 patients with RA associated with negative U waves, 4 died. Although the mechanism of the negative U wave is not yet known, we believe that the above findings contribute to its elucidation.
在变异型心绞痛发作时偶尔会出现极其明显的负向U波。因此，对80例变异型心绞痛（VA）患者和33例静息型心绞痛（RA）对照者的负向U波临床特征进行了研究。55例VA患者（占患者的68.8%）出现了明显的负向U波，10例RA患者（占30.3%）出现了该波；因此，两组患者中该波的出现存在显著差异（p<0.001）。负向U波出现的导联大多与ST段抬高的导联一致。负向U波大约在ST段抬高开始改善时开始出现；随后该波逐渐变得非常明显，最终消失。在运动试验时心电图上出现负向U波的VA患者以及RA患者，在心绞痛自发发作时也有负向U波。对无论何种类型心绞痛患者运动试验时ST段偏移和负向U波出现频率的调查显示，20例ST段抬高患者中有14例（占患者的70%）出现了负向U波，而519例无ST段改变或ST段压低患者中仅有52例（占10.4%）出现了负向U波；因此，这两组患者中负向U波的出现存在显著差异（p<0.001）。冠状动脉造影未能揭示负向U波的出现与狭窄存在之间有任何明显差异。与无负向U波的患者相比，有负向U波的VA和RA患者预后较差。特别是，我们注意到10例伴有负向U波的RA患者中有4例死亡。虽然负向U波的机制尚不清楚，但我们认为上述发现有助于对其进行阐明。
