Open AccessAppearance of Electrocardiographic Initial U‐Wave Inversion Dependent on Pressure‐Induced Early Diastolic Impairment in Patients with Hypertension
Author(s) -
Miwa Kunihisa
Publication year - 2009
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20487
Subject(s) - medicine , t wave , inversion (geology) , blood pressure , u wave , cardiology , diastole , pressure wave , anesthesia , electrocardiography , mechanics , geology , seismology , tectonics , physics
Background ECG U‐wave inversion can be classified as initial and terminal U inversion according to the phasic relationship to positive U‐wave deflection. Initial U inversion is occasionally observed in hypertensive patients while terminal U inversion frequently appears during severe myocardial ischemia. Hypothesis The genesis of initial U inversion may be related to pressure‐induced diastolic dysfunction. Methods In order to clarify the genesis of initial U‐wave inversion we studied 11 consecutive hypertensive patients with both initial U inversion and impaired left ventricular early relaxation who were evaluated using Doppler echocardiography. Results The U inversion disappeared during acute pressure lowering by sublingual administration of nitroglycerin. The U inversion also disappeared and relaxation improved significantly after chronic blood pressure lowering. Initial U inversion reappeared during a cold pressor test. Conclusion The appearance of initial U inversion was dependent on the pressure‐induced impaired left ventricular early relaxation in hypertensive patients. Copyright © 2009 Wiley Periodicals, Inc.