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New protocol to detect coronary spastic angina without fixed stenosis
Shozo Sueda1, Haruhisa Hashimoto, Naoto Ochi
1Department of Cardiology, Kita Medical Association Hospital, Yoshida General Hospital, Ehime, Japan.
Japanese Heart Journal
|September 14, 2002
Summary
A new combined test of hyperventilation and exercise effectively detects coronary vasospasm in patients with normal arteries. This diagnostic tool shows higher sensitivity for vasospastic angina compared to individual tests.
Area of Science:
- Cardiology
- Diagnostic Medicine
- Clinical Research
Background:
- Coronary vasospasm in patients with near-normal coronary arteries presents diagnostic challenges.
- Existing non-invasive tests for coronary artery spasm have limitations in sensitivity.
Purpose of the Study:
- To evaluate the effectiveness of a novel combined hyperventilation and exercise test for diagnosing coronary vasospasm.
- To compare the sensitivity and specificity of this new test against individual hyperventilation and exercise tests.
Main Methods:
- A new combined test involving accelerated exercise after mild hyperventilation (HV) was developed.
- Fifty-eight patients with pharmacologically-induced coronary vasospasms and no significant stenosis underwent sequential HV, treadmill exercise test (TET), and the combined test.
- Forty-six healthy controls with near-normal coronary arteries were included for specificity assessment.
Main Results:
- The combined test demonstrated a sensitivity of 63% (35/56), significantly higher than HV (16%) and TET (26%).
- All tests exhibited 100% specificity in the control group.
- No serious complications were reported during the testing procedures.
Conclusions:
- The combined hyperventilation and exercise test is a sensitive and specific diagnostic tool for coronary vasospasm in patients without significant coronary artery stenosis.
- This protocol offers an improved approach for diagnosing vasospastic angina pectoris.