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U wave inversion

MedGen UID:
1370051
•Concept ID:
C4476578
•
Finding
HPO: HP:0025071

Definition

Direction of the U wave opposite to the T wave (i.e., below baseline) in leads with upright T waves. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVU wave inversion

Professional guidelines

PubMed

Evaluation of the Seattle and International Criteria in elite Nigerian athletes.
Ilodibia TF, Odia JO
J Electrocardiol 2021 Sep-Oct;68:14-23. Epub 2021 Jul 7 doi: 10.1016/j.jelectrocard.2021.06.007. PMID: 34273803
Diagnostic Yield of Genetic Testing in Young Athletes With T-Wave Inversion.
Sheikh N, Papadakis M, Wilson M, Malhotra A, Adamuz C, Homfray T, Monserrat L, Behr ER, Sharma S
Circulation 2018 Sep 18;138(12):1184-1194. doi: 10.1161/CIRCULATIONAHA.118.034208. PMID: 29764897Free PMC Article
American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography.
Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK, Rodriguez ER, Schaff HV, Schoenhagen P, Tan CD, White RD
J Am Soc Echocardiogr 2013 Sep;26(9):965-1012.e15. doi: 10.1016/j.echo.2013.06.023. PMID: 23998693

Recent clinical studies

Etiology

Coronary heart disease diagnosis bases on the change of different parts in treadmill exercise test ECG.
Jian-ling S, Ying Z, Yu-lian G, Li-juan X, Ji-hong G, Xiao-ying L
Cell Biochem Biophys 2013;67(3):969-75. doi: 10.1007/s12013-013-9591-y. PMID: 23546936
Occurrence of transient U-wave inversion during vasospastic anginal attack is not related to the direction of concurrent ST-segment shift.
Kodama-Takahashi K, Ohshima K, Yamamoto K, Iwata T, Hamada M, Hiwada K, Murakami E
Chest 2002 Aug;122(2):535-41. doi: 10.1378/chest.122.2.535. PMID: 12171828
Transient U wave inversion during treadmill exercise testing in patients with left anterior descending coronary artery disease.
Kodama K, Hiasa G, Ohtsuka T, Ikeda S, Hashida H, Kuwahara T, Hara Y, Shigematsu Y, Hamada M, Hiwada K
Angiology 2000 Jul;51(7):581-9. doi: 10.1177/000331970005100706. PMID: 10917582
Negative U wave during percutaneous transluminal coronary angioplasty.
Yano H, Hiasa Y, Aihara T, Nakaya Y, Mori H
Clin Cardiol 1991 Mar;14(3):232-6. doi: 10.1002/clc.4960140311. PMID: 2013180
Transient U wave inversion during variant angina.
Matsuguchi T, Koiwaya Y, Nakagaki O, Takeshita A, Nakamura M
Am Heart J 1984 Oct;108(4 Pt 1):899-904. doi: 10.1016/0002-8703(84)90452-6. PMID: 6486000

Diagnosis

The negative U wave: a pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease.
Correale E, Battista R, Ricciardiello V, Martone A
Clin Cardiol 2004 Dec;27(12):674-7. doi: 10.1002/clc.4960271203. PMID: 15628108Free PMC Article
Occurrence of transient U-wave inversion during vasospastic anginal attack is not related to the direction of concurrent ST-segment shift.
Kodama-Takahashi K, Ohshima K, Yamamoto K, Iwata T, Hamada M, Hiwada K, Murakami E
Chest 2002 Aug;122(2):535-41. doi: 10.1378/chest.122.2.535. PMID: 12171828
Transient terminal U wave inversion as a more specific marker for myocardial ischemia.
Miwa K, Miyagi Y, Fujita M, Fujiki A, Sasayama S
Am Heart J 1993 Apr;125(4):981-6. doi: 10.1016/0002-8703(93)90104-h. PMID: 8465770
U wave inversion during attacks of variant angina.
Miwa K, Murakami T, Kambara H, Kawai C
Br Heart J 1983 Oct;50(4):378-82. doi: 10.1136/hrt.50.4.378. PMID: 6626401Free PMC Article
Exercise-induced U-wave inversion as a marker of stenosis of the left anterior descending coronary artery.
Gerson MC, Phillips JF, Morris SN, McHenry PL
Circulation 1979 Nov;60(5):1014-20. doi: 10.1161/01.cir.60.5.1014. PMID: 487534

Therapy

Elimination of isolated exercise-induced U wave inversion after successful percutaneous transluminal coronary angioplasty of left anterior descending artery.
Scholl JM, Wagniart P, Morice MC, Charlier P, Morin B, Daffos C
Am Heart J 1987 Jul;114(1 Pt 1):166-9. doi: 10.1016/0002-8703(87)90323-1. PMID: 2955686
Present status of exercise testing in the evaluation of coronary artery disease.
Sotobata I, Kondo T, Kawai N
Jpn Circ J 1981 Mar;45(3):381-95. doi: 10.1253/jcj.45.381. PMID: 7206192

Prognosis

Appearance of electrocardiographic initial U-wave inversion dependent on pressure-induced early diastolic impairment in patients with hypertension.
Miwa K
Clin Cardiol 2009 Oct;32(10):593-6. doi: 10.1002/clc.20487. PMID: 19816990Free PMC Article
The negative U wave: a pathogenetic enigma but a useful, often overlooked bedside diagnostic and prognostic clue in ischemic heart disease.
Correale E, Battista R, Ricciardiello V, Martone A
Clin Cardiol 2004 Dec;27(12):674-7. doi: 10.1002/clc.4960271203. PMID: 15628108Free PMC Article
Occurrence of transient U-wave inversion during vasospastic anginal attack is not related to the direction of concurrent ST-segment shift.
Kodama-Takahashi K, Ohshima K, Yamamoto K, Iwata T, Hamada M, Hiwada K, Murakami E
Chest 2002 Aug;122(2):535-41. doi: 10.1378/chest.122.2.535. PMID: 12171828
Negative U wave during percutaneous transluminal coronary angioplasty.
Yano H, Hiasa Y, Aihara T, Nakaya Y, Mori H
Clin Cardiol 1991 Mar;14(3):232-6. doi: 10.1002/clc.4960140311. PMID: 2013180
Exercise-induced U-wave inversion as a marker of stenosis of the left anterior descending coronary artery.
Gerson MC, Phillips JF, Morris SN, McHenry PL
Circulation 1979 Nov;60(5):1014-20. doi: 10.1161/01.cir.60.5.1014. PMID: 487534

Clinical prediction guides

Appearance of electrocardiographic initial U-wave inversion dependent on pressure-induced early diastolic impairment in patients with hypertension.
Miwa K
Clin Cardiol 2009 Oct;32(10):593-6. doi: 10.1002/clc.20487. PMID: 19816990Free PMC Article
Occurrence of transient U-wave inversion during vasospastic anginal attack is not related to the direction of concurrent ST-segment shift.
Kodama-Takahashi K, Ohshima K, Yamamoto K, Iwata T, Hamada M, Hiwada K, Murakami E
Chest 2002 Aug;122(2):535-41. doi: 10.1378/chest.122.2.535. PMID: 12171828
Transient terminal U wave inversion as a more specific marker for myocardial ischemia.
Miwa K, Miyagi Y, Fujita M, Fujiki A, Sasayama S
Am Heart J 1993 Apr;125(4):981-6. doi: 10.1016/0002-8703(93)90104-h. PMID: 8465770
U wave inversion during attacks of variant angina.
Miwa K, Murakami T, Kambara H, Kawai C
Br Heart J 1983 Oct;50(4):378-82. doi: 10.1136/hrt.50.4.378. PMID: 6626401Free PMC Article
Exercise-induced U-wave inversion as a marker of stenosis of the left anterior descending coronary artery.
Gerson MC, Phillips JF, Morris SN, McHenry PL
Circulation 1979 Nov;60(5):1014-20. doi: 10.1161/01.cir.60.5.1014. PMID: 487534

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