冠動脈疾患の3例に認められた一過性陰性U波

Significance of transient U-wave inversion in coronary arstery disease:a report of 3 cases

はじめに

　陰性U波の成因については，未だ不明の部分が多いが，種々循環器疾患において認められる病的所見であると考えられている^1〜3）。

　今回私達は，各々に病態の異なる冠動脈疾患の3例において，一過性の陰性U波出現を認めたので，その意義について若干の文献上の考察を加え報告する。

Negative U-wave has been regarded as a predic-tor of organic heart disease, although its precise mechanism has not been well defined. Recently, Gerson and colleagues, in their cineangiographic study, discovered the transient U-wave inversion in the left precordial leads of 12-lead ECG to be of value indicating the disease of proximal left anterior descending (LAD) coronary artery.

In this report, 3 cases with such U-wave change developed during the episode of trnsient myocardialischemia (by exercise testing in the Case-1 with postinfarction angina and Case-2 with stable effort angina, and during spontaneous variant angina in Case-3) were presented. Coronary angiographies performed in all cases disclosed significant stenosis on the proximal or mid LAD.

In conclusion, transiently inverted U-wave in the left precordial leads coinciding with the episode of myocardial ischemia was highly predictive to the significant stenosis of LAD, not only in effort angina but in variant angina also.