Clinical significance of exercise-induced negative U-waves in patients with anterior myocardial infarction.
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概要
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To elucidate the clinical significance of the exercise-induced negative U-wave (NU) in patients with anterior myocardial infarction, we compared the angiographic and scintigraphic findings in 15 patients with and 20 patients without NU, and obtained the following results:1) On coronary angiography, all patients in the NU (+) group showed over 90% stenosis or total occlusion of the left anterior descending coronary artery (LAD). In the latter cases moderate to abundant collaterals were visualized on the anterior wall. In contrast, such a tendency was not observed in the NU (-) group.2) Segments composed of viable myocardium (estimated by preservation of contraction at rest and Tl-201 redistribution after exercise) numbered 30 of 45 segments (67%) in the NU (+) group, and 13 of 60 segments (22%) in the NU (-) group. Segments composed of lost myocardium (estimated by loss of contraction at rest and persistent defect in Tl-201 uptake) numbered 7 of 45 segments (16%) in the NU (+) group, and 38 of 60 segments (63%) in the NU (-) group.3) Exercise-induced NU was frequently observed on R-wave preserved leads with ST depression, but was also observed over abnormal Q waves, ST elevation and in isolation in some instances.4) In 3 patients, preexisting exercise-induced NU was no longer observed and a transient stress-induced Tl-201 defect disappeared after successful LAD revascularization.In conclusion, exercise-induced NU on precordial leads in patients with anterior myocardial infarction may be a sign suggesting the presence of jeopardized, but still salvageable, myocardium in the infarcted area.
- International Heart Journal刊行会の論文
著者
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Ono Shoichi
Department Of Cardiology Kanto Teishin Hospital
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Fu Long
The Cardiovascular Institute
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Murayama Masahiro
Department Of Applied Chemistry
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Sakamoto Shizuo
Department Of Cardiology Kanto Teishin Hospital
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Itai Tsutomu
Department Of Cardiology Kanto Medical Center Ntt Ec
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Kawakubo Kiyoshi
Department Of Cardiology Kanto Teishin Hospital
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Musha Haruki
Department Of Cardiology St. Marianna University School Of Medicine
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Ito Hiroyuki
Department Of Anesthesiology Tokyo Medical And Dental University Graduate School Of Medical And Dent
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SAKAMOTO Shizuo
Department of Cardiology, Kanto-Teishin Hospital
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MURAYAMA Masahiro
Department of Cardiology, Kanto-Teishin Hospital
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KAWAKUBO Kiyoshi
Department of Cardiology, Kanto-Teishin Hospital
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KATOH Norihisa
Department of Cardiology, Kanto-Teishin Hospital
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ITAI Tsutomu
Department of Cardiology, Kanto-Teishin Hospital
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ONO Shoichi
Department of Cardiology, Kanto-Teishin Hospital
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