Exercise-Induced U-Wave Changes in Patients With Coronary Artery Disease

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  • Miyakoda Hiroyuki
    First Department of Internal Medicine, Tottori University School of Medicine
  • Endo Akihiro
    First Department of Internal Medicine, Tottori University School of Medicine
  • Kato Masahiko
    First Department of Internal Medicine, Tottori University School of Medicine
  • Kato Tatsuo
    First Department of Internal Medicine, Tottori University School of Medicine
  • Omodani Hiroki
    First Department of Internal Medicine, Tottori University School of Medicine
  • Osaki Shuichi
    First Department of Internal Medicine, Tottori University School of Medicine
  • Kinugawa Toru
    First Department of Internal Medicine, Tottori University School of Medicine
  • Hoshio Akira
    First Department of Internal Medicine, Tottori University School of Medicine
  • Mashiba Hiroto
    Kure Kyosai Hospital

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  • Correlation With Tomographic Thallium-201 Myocardial Imaging

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We studied the relation between exercise-induced U-wave changes and the site of a reversible defect in tomographic 201T1 myocardial imaging. Coronary artery disease and control groups consisted of 116 and 42 patients, respectively. In the anteroapical-ischemia group (n=37), the sensitivity of U-wave inversion in the anterior precordial leads for ischemia was 62% (23/37) and that of prominent U-waves without an increase in the height of the T-wave in the inferior limb leads was 57% (21/37). In this group, 18 patients (49%) met both criteria (18 [78%] of 23 patients with the former; 18 [86%] of 21 patients with the latter). In the posterior-ischemia group (n=59), the sensitivity of prominent U-waves with a decrease in the height of the T-wave in the anterior precordial leads for ischemia was 63% (37/59) and that of U-wave inversion in the inferior limb leads was 20% (12/59). In this group, 12 patients (20%) met both criteria (12 [32%] of 37 patients with the former; all 12 patients with the latter). The specificity of U-wave criteria was 100%. In the anteroapical and posterior-ischemia group (n=20), the sensitivity of U-wave criteria for anteroapical and posterior ischemia was 85% (17/20) and 40% (8/20), respectively. In conclusion, U-wave criteria are not only specific but also sensitive for myocardial ischemia determined by 201Tl imaging. (Jpn Circ J 1996; 60: 641 - 651)

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