Miwa K, Murakami T, Kambara H, Kawai C
Br Heart J. 1983 Oct;50(4):378-82. doi: 10.1136/hrt.50.4.378.
Sequential 12 lead electrocardiograms were recorded during angina pectoris induced by ergonovine maleate in 38 patients with variant angina. Transient U wave inversion was observed in 17 patients with ST segment elevation in anterior chest leads, but in only three of 21 patients with ST segment elevation in the inferior leads associated with right coronary artery spasm. In the 17, all of whom had spasm of the left anterior descending coronary artery, the sensitivity of ST segment elevation in V5 was only 41%, and that of U wave inversion 71%. U wave inversion without ST segment elevation occurred during attacks in 35% of patients. During the recovery phase, the sensitivity of U wave inversion was 82% in V4 and 65% in V5, though ST segment elevation was absent in both V4 and V5. Thus, inverted U waves without ST segment elevation often appear in marginal ischaemic zones or during the time of recovery from temporary ischaemia. Detection of inverted U waves should aid in the diagnosis of variant angina when only lead V5 is used as a monitor and when electrocardiograms are recorded only during the recovery phase.
对38例变异型心绞痛患者，在马来酸麦角新碱诱发心绞痛发作期间记录连续12导联心电图。在前胸导联ST段抬高的17例患者中观察到短暂U波倒置，但在21例下壁导联ST段抬高伴右冠状动脉痉挛的患者中仅3例出现U波倒置。在这17例均有左前降支冠状动脉痉挛的患者中，V5导联ST段抬高的敏感性仅为41%，U波倒置的敏感性为71%。35%的患者在发作期间出现无ST段抬高的U波倒置。在恢复阶段，尽管V4和V5导联均无ST段抬高，但V4导联U波倒置的敏感性为82%，V5导联为65%。因此，无ST段抬高的倒置U波常出现在边缘缺血区或暂时缺血恢复期间。当仅将V5导联用作监测导联且仅在恢复阶段记录心电图时，检测到倒置U波应有助于变异型心绞痛的诊断。
