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European Heart Journal 1989 10(Supplement F):101-104; doi:10.1093/eurheartj/10.suppl_F.101
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

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, Chimienti and J. A. Salerno

Division of Cardiology, IRCCS Policlinico S. Matteo and Department of Internal Medicine, Section of Cardiology, University of Pavia Pavia, Italy

Correspondence: Mario Previtali, Division of Cardiology, IRCCS Policlinico S. Matteo, Piazzale Golgi, 27100 Pavia, Italy

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.

Key Words: hyperventilation • ergonovine • variant angina • coronary vasospasm


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