Prognosis of patients with persistent negative U wave following myocardial infarction.

Abstract

SUMMARYIn order to clarify the clinical significance of a persistent negative U wave in patients with myocardial infarction, the clinical features and prognosis of a group of such patients were compared with a group without negative U waves. The persistent negative U wave was defined as the presence of a negative U wave at the time of discharge. The subjects were classified into 2 groups: group A-55 patients (50 males and 5 females, 5910 years) with negative U waves; group B-70 patients (55 males and 15 females, 619 years) without negative U waves. The average follow-up periods were 4921 months in group A and 4218 months in group B. Negative U waves appeared in leads where r or R waves were present, but were not observed in leads with a QS pattern. The incidences of a diseased left anterior descending artery, multi-vessel disease, left ventricular wall motion abnormality and left ventricular ejection fraction below 50% were higher in group A than in group B. The recurrence of myocardial infarction was 18.2% in group A and 7.1% in group B, and the number of patients treated with antianginal drugs was higher in group A than in group B. The rate of recurrence of myocardial infarction at 1, 3 and 5 years was 6%, 17% and 26%, respectively in group A and 6%, 8% and 11%, respectively in group B. Thus, it was concluded that patients in group A require more active treatment than those in group B. Additional Indexing Words: Recurrent myocardial infarctionClinical course of myocardial infarction Aortocoronary bypass graft Mechanism of negative U wave Genesis of U wave

Negative u wave during percutaneous transluminal coronary angioplasty

“…I 6 . l 7 The Purkinje repolarization hypothesis advocated by Hoffman and Cranefield l 3 was supported by the clinical electrocardiographic and experimental studies of Watanabe. l4 On the other hand, Lepeschkin' advocated the negative afterpotential hypothesis.…”

Prevalence and Prognostic Significance of Negative U-waves in a 12-lead Electrocardiogram in the General Population

“…The prognostic significance of negative U-waves has been studied only in special patient populations. In hypertensive subjects negative U-waves have been associated with higher morbidity and mortality 23 , and among patients with recent myocardial infarction, negative U-waves have been associated with reduced left ventricular ejection fraction, more advanced disease and increased infarction recurrence rates 10 . However, the prognostic significance of negative U-waves has not been studied in the general population.…”

“…However, negative U-waves are a much less frequent phenomenon 5 , and are often associated with cardiac diseases 6 9 . The prognostic significance of U-wave morphologies has been studied mostly in specific cardiac patient populations 10 . However, data are lacking on the prognostic significance of different U-wave manifestations in the general population.…”