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KMID : 0438219730100030879
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Korea University Medical Journal
1973 Volume.10 No. 3 p.879 ~ p.892
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Studies on the U wave of Elctrocardiogram
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Abstract
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The U wave of the electrocardiogram was recognized about 60 years ago by Einthoven, but little attention has been payed in clinical electrocardiography, and its significance was not clear. During the last 30 years, number of reports has appeared in which changes of the U wave was found to be the chief clue leading to the correct diagnosis. However, the reports of clinical significance and genesis of U wave were controversial.
Author analysed electrocardiograms of 288 cases of normal persons, 406 cases of hypertension and 212 cases of pre-and postexercise electrocardiogram(normal person 158 cases, angina pectoris 22 cases, hypertension 25 cases, diabetes mellitus 7 cases) and following results were obtained;
A. U-waves in normal persons.
1. Incidences of measurable U wave (higher than 0.2mm) were 96.6% in unipolar precordial lead, 24.3% in standard lead and 19.8% in unipolar limb lead.
2. Incidence of U wave in standard and unipolar limb lead was higher in female and in precordial lead were higher in male.
3. Height of U wave were not related with age in both sex.
4. The most prominent U wave in the precordial lead was seen in V₃.
B. U waves in hypertension.
1. Negative U wave was seen in 19.7% of hypertension (22.9% of male, 18.8% of female) and most prominent in V^(6).
2. Systolic and diastolic blood pressure was significantly higher in negative U wave group than positive U wave group, and incidence of negative U wave was not related with age.
3. Secondary U wave change (negative U wave secondary to T wave inversion) was 29.8% of hypertension and isolated negative U wave was 12.8%.
4. Types of negative U wave in hypertension were negative 48%, diphasic 36% and continuous type 16%.
5. Incidence of high U wave (over 1mm) in hypertension was significantly higher than that of normal person.
C. U wave changes after simple Master´s test.
1. U wave changes after Master´s test in normal person occurred in 36.2%, which were enlarged (25.8%), decreased (5.2%) and negative U wave (5.2%). The incidences of positive Master´s test was higher in negative or decreased U wave groups than that of enlarged and unchanged groups.
2. Incidence of positive Master´s test was higher in negative U wave before exercise than in positive U wave, But it was not related with U wave changes after exercise.
3. U wave changes after Master´s test in hypertension occurred in 32%, which was negative(16%), enlarged (12%) and decreased U wave (4%). Incidences of positive Master´s test was higher in negative and decreased U wave groups than that of decreased and no change groups which was similar to normal person.
Abnormal U waves were seen in myocardial ischemia and ventricular distention such as in coronary heart disease and hypertension. But we could not suggest the degree of myocardial ischemia and ventricular distention by U wave changes for there were many cases of normal U wave after exercise in angina pectoris and high blood pressure. It was suggested that abnormal U wave was additional finding to ST, T changes of electrocardiogram for the correct diagnosis of myocardial ischemia or ventricular distention.
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KEYWORD
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