Hyperventilation and ergonovine tests in Prinzmetal's variant angina: Comparative sensitivity and relation with the activity of the disease

M. Previtali, D. Ardissino, C. Storti, R. De Ponti, [No Value] Chimienti, J. A. Salerno

Research output: Contribution to journalArticlepeer-review

Abstract

Hyperventilation (HV) and ergonovine (E) tests were carried out in a group of 32 patients with variant angina to compare their sensitivity and to correlate the results with the activity of the disease. The HV test was positive in 84% of the patients and E in 94% of them; the percentage of positive responses to HV was similar to that to E (96% vs 100%) in the patients with daily attacks, while it was lower (55% vs 77%) in those with sporadic attacks. All 27 patients with a positive HV also had a positive response to E, while of the five patients with a negative HV, two also had a negative response to E and the other three had a positive E at a higher dose than that of the patients with daily attacks. The incidence of chest pain and of ST-segment elevation or depression or T-wave positivization was similar during the two tests; however, spontaneous remission of ischaemia was more frequent after HV than after E and ventricular arrhythmias less frequent during the HV test. At the onset of myocardial ischaemia pH was significantly higher compared with basal values (7.51 ± 0.07 vs 7.38 ± 0.05, P <0.001), while double product was not significantly different compared with basal (10.0 ± 2.4 vs 9.2 ± 2.1). Thus the response to HV and E is closely correlated with the activity of the disease; HV has a sensitivity similar to E only in patients with daily attacks, while in those in a less active phase of the disease it has a lower sensitivity than E and therefore seems to be of limited diagnostic value in patients with suspected variant angina.

Original languageEnglish
Pages (from-to)101-104
Number of pages4
JournalEuropean Heart Journal
Volume10
Issue numberSUPPL. F
Publication statusPublished - 1989

Keywords

  • Coronary vasospasm
  • Ergonovine
  • Hyperventilation
  • Variant angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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