Correlation between Isolated Negative U Waves and the Grade Coronary Artery Spasm

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概要

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• The relation between isolated negative U waves and the severity of induced coronary artery spasm was investigated in 24 patients with variant angina to determine the grade of myocardial ischemia during the appearance of isolated negative U waves. Coronary artery spasm was induced by injections of either incremental doses of acetylcholine or ergonovine into the left coronary artery. Coronary spasm was quantified into 4 grades : Grade 0=complete perfusion, Grade 1=partia1 perfusion, Grade 2=penetration without perfusion, and Grade 3=no perfusion. Induction with acetylcholine was discontinued when a coronary spasm of Grade ≥2 was induced. Electrocardiogram in leads V1 to V6 and systemic blood pressure were recorded continuously. Provocations of coronary spasm with at least 2 doses'of acetylcholine could be performed in 15 patients. All acetylcholine-induced coronary spasms of Grade ≤1 disappeared spontaneously within 3 min. Negative U waves developed in 19 (79%) patients, in whom 37 trials with acetylcholine or ergonovine injection were performed. Isolated negative U waves were detected in 10 trials, negative U waves and ST depression in 8 trials, and negative U waves and ST elevation in 14 trials. The induced coronary spasms associated with isolated negative U waves were of Grade 1 in 9 of the 10 trials. In contrast, all of the coronary spasms associated with negative U waves and ST elevation had a Grade of ≥2. In conclusion, the coronary angiographic finding associated with isolated negative U waves is coronary spasm with delayed filling of the distal coronary artery, with opacification of the entire coronary bed.

• 社団法人日本循環器学会の論文
• 1995-01-20

著者

• Shibata Akira

  Division Of Cardiology Niigata University Graduate School Of Medical And Dental

• Shibata A

  Division Of Cardiology Niigata University Graduate School Of Medical & Dental Sciences

• Yamazoe Masaru

  First Department of Internal Medicine, Niigata University School of Medicine

• Igarashi Yutaka

  Tsuruoka City Shonai Hospital

• Tamura Yusuke

  1st. Department Of Internal Medicine Niigata University School Of Medicine

• Tanabe Yasuhiko

  Saiseikai Niigata Daini Hospital

• Yamaura Masayuki

  Department Of Cardiology Niigata City General Hospital

• Murakawa Yuji

  The Second Department Of Internal Medicine. Faculty Of Medicine University Of Tokyo

• Shibata Akira

  First Department of Internal Medicine Niigata University School of Medicine

• Tanabe Yasuhiko

  Department Of Internal Medicine Niigata Prefectural Shibata Hospital

• Shibata Akira

  The First Department Of Internal Medicine Niigata University School Of Medicine Tachikawa Hospital T

• Yamazoe Masaru

  Niigata City General Hospital

• Yamazoe Masaru

  First Department Of Internal Medicine

• Igarashi Yutaka

  First Department of Internal Medicine, Niigata University School of Medicine

• Tamura Yusuke

  First Department of Internal Medicine, Niigata University School of Medicine

• Tanabe Yasuhiko

  First Department of Internal Medicine, Niigata University School of Medicine

• Fujita Toshio

  First Department of Internal Medicine, Niigata University School of Medicine

• Tanaka Yoshiaki

  First Department of Internal Medicine, Niigata University School of Medicine

• Shibata Akira

  First Department Of Internal Medicine Niigata University Niigata Case Western Reserve University

• Tamura Yusuke

  First Department Of Internal Medicine Niigata University School Of Medicine

• Shibata Akira

  The First Department Of Internal Medicine Niigata University School Of Medicine

• Igarashi Yutaka

  First Department Of Internal Medicine Niigata University School Of Medicine

• Yamazoe Masaru

  First Department Of Medicine Niigata University

• Makiyama Yashiro

  Niigata City General Hospital

• Igarashi Yutaka

  The First Department Of Internal Medicine Niigata University School Of Medicine

• Murakami Yuji

  The Second Department Of Internal Medicine. Faculty Of Medicine University Of Tokyo

• Fujita Toshio

  First Department Of Internal Medicine Niigata University School Of Medicine

• Shibata Akira

  The 1st. Depertment Of Internal Medicine Niigata University School Of Medicine.

• TANABE Yasuhiko

  First Department of Internal Medicine Niigata University School of Medicine

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