大動脈弁閉鎖不全における陰性Ｕ波の意義

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  • Studies on negative U waves in patients with aortic regurgitation.
  • ダイドウミャクベン ヘイサフゼン ニ オケル インセイ Uハ ノ イギ

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The purpose of this study is to clarify the clinical significance of negative U waves (NU) in patients with aortic regurgitation (AR). Out of 126 patients with AR, 57 patients (36 men and 21 women) with sinus rhythm and without AS (3), MS (17), atrial fibrillation (18), and unclear U waves were served as subjects. Ages ranged from 17 to 83 years with an average of 51.11 apparantly healthy subjects were choosen as control (6 men and 5 women, average of 43 years). NU were noted in 42 of 57 AR patients (73.6%) in contrast to 3 of 17 patients (17.6%) with AR and MS and no one in control group. AR patients were divided into 3 groups according to the polarity of T and U waves (TPUP, TPUN, TNUN) and left ventricular function obtained from M-mode UCG were studied including normal control (NC). LVEF decreased in order from NC (71.2±3.8%), TPUP (66.9±5.4%), TPUN (63.5±6.7%) to TNUN (53.1±10.9%). Mean Vcf also took the same tendency; that is, 1.27±0.12, 1.16±0.12, 1.02±0.14 and 0.81±0.15circ/sec, respectively. There are positive correlations between SV1+RV5 and LVDd (r=0.480) and also IVST+PWT (0.497); amplitude of T waves and amplitude of U waves (r=0.533, p<0.01); amplitude of U waves and EF (r=0.496, p<0.01) and mean Vcf (r=0.659, p<0.01). As to the relationship to ages; amplitude of U waves decreased in order with statistically significant changes from younger age group (n=17, 0.05±0.02mV), middle age group (n=23, -0.04±0.02mV) to older age group (n=17, -0.07±0.04mV). There were significant negative correlations between age and EF (r=-0.478, p<0.01) and age and mean Vcf (r=-0.595, p<0.01). Therefore, we conclude that negative U wave in patients with aortic regurgitation increase in frequency with ageing and is the sign suggesting both decreased myocardial and pump function of the left ventricle.

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