Hemodynamic characteristics of echocardiographic findings in hypertensive patients with negative U waves and effect of an antihypertensive drug, tripamide.

Kuroda, Hiroshi; Takiguchi, Fuyuko; Sugiki, Yuji; Kuroki, Shunsuke; Tsuruo, Takashi; Seino, Y; Sasaki, Hiroyuki; Fukuda, Jun; Matsuo, Shogo

doi:10.1536/ihj.28.377

Cited by 2 publications

(2 citation statements)

References 15 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 In hypertensive patients with an nU, hypotensive treatment determined a reduction of both endsystolic and end-diastolic dimensions. 11 A decrease in high voltage of the QRS has been reported with regression of an nU, 10 with the high voltage attributed to dilatation of the ventricle due to the Brody effect. 10,42,43 The pressure-volume changes during ischemia also indicate a change in distensibility of the ventricle.…”

Section: Pathogenesis Of the Negative U Wavementioning

confidence: 97%

“…With rare exceptions, a negative U wave (nU) is considered a pathologic sign, mostly of cardiac origin. 5,9,10 An nU has been reported in aortic and mitral regurgitation, myocardial hypertrophy, hypertension, [9][10][11][12][13] dilated cardiomyopathy, 14 myocardial ischemia during exercise 9,15-17 and pharmacologic tests, 5,9,18 vasospastic angina, 8,19,20 during percutaneous transluminal coronary angioplasty (PTCA), 6,7,21 with anterior descending pathology 9, 22-25 when a vast myocardial territory is involved by ischemia regardless of the culprit vessel, 7,19,26 and in previous anterior myocardial infarctions. 27,28 In 488 patients with an nU, the primary diagnosis was hypertension in 39.5%, coronary disease in 33.7%, and valvular disease in 15.4%.Of these, 81.3% with isolated aortic valvular disease had regurgitation; no evident heart disease was found in only 7.2%.…”

Section: The Negative U Wavementioning

confidence: 99%

See 1 more Smart Citation

The negative U wave: A pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease

Correale¹,

Battista²,

Ricciardiello³

et al. 2004

Clinical Cardiology

View full text Add to dashboard Cite

Summary:The pathogenesis of U-wave inversion and its clinical value are still not clear, although the U wave was described by Einthoven together with the other electrocardiographic (ECG) waves. Not considered a useful diagnostic clue, it is not usually mentioned in ECG reports. In recent years, stimulated by the long QT syndromes and by the discovery of U-wave changes in some pathologic, mostly cardiac states, this neglected wave has attracted new interest. This review focuses on the negativity of the U wave in ischemic heart disease. The discovery of M cells and their electrophysiology has established the cellular basis for repolarization and has contributed to our knowledge of U-wave genesis. Hemodynamic changes during diastole in acute ischemia also furnish interesting elements for the interpretation of U-wave changes, and some experimental and clinical studies, besides designating stretch as a cause of U-wave changes, have also proved their value for more accurate bedside diagnosis and prognosis. They may indicate the extent of myocardial ischemia, the presence of collateral circulation, and the possible territory and vessel involved. When U-wave changes are the first and only sign of ischemia, they may contribute to a decision regarding the hospital admission of a patient without typical ischemic symptoms. Furthermore, U-wave changes during exercise tests increase their sensitivity.

show abstract

Section: Pathogenesis Of the Negative U Wavementioning

confidence: 97%

Section: The Negative U Wavementioning

confidence: 99%

The negative U wave: A pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease

Correale¹,

Battista²,

Ricciardiello³

et al. 2004

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

Negative U-wave as a Predictor of Antihypertensive Treatment Effect on Regression of Echocardiographic Hypertrophy in Hypertensive Patients.

et al. 1999

View full text Add to dashboard Cite

To clarify the mechanism and the predictors of the reduction in left ventricular mass (LVM) induced by antihypertensive drugs, forty hypertensive patients were classified according to the presence of left ventricular hypertrophy (LVH) as a defined by echocardiographic LVM findings (LVH group: 27 patients, non-LVH group: 13 patients) and according to the presence of negative U-waves (NU) (NU group: 10 patients, non-NU group: 30 patients). Negative U-waves appeared in the LVH group only (10 of 27 patients). The hemodynamic determinants were investigated as a mechanism of LVM reduction in 38 of these patients who were treated for 2 years with antihypertensive drugs. In the LVH group, thickness of interventricular septum (IVST), posterior wall thickness (PWT) and LVM increased significantly compared to the non-LVH group. In the NU group, the left ventricular end-diastolic dimension (LVDD) was significantly larger and the relative wall thickness was significantly smaller compared to the non-NU group in the LVH group, with no difference in LVM between the two groups. Negative U-waves disappeared in all cases after treatment. Significant decreases in LVDD and LV wall thickness were observed in the NU group and significant decrease in LV wall thickness in the non-NU group. LVM index was reduced by 24.0% in the NU group and 9.5% in the non-NU group. The disappearance of negative U-waves was an independent predictor of the reduction of LVH.

show abstract

Hemodynamic characteristics of echocardiographic findings in hypertensive patients with negative U waves and effect of an antihypertensive drug, tripamide.

Cited by 2 publications

References 15 publications

The negative U wave: A pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease

The negative U wave: A pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease

Negative U-wave as a Predictor of Antihypertensive Treatment Effect on Regression of Echocardiographic Hypertrophy in Hypertensive Patients.

Contact Info

Product

Resources

About