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Related Experiment Videos

Circadian variation in variant angina.

D D Waters, D D Miller, A Bouchard

    The American Journal of Cardiology
    |July 1, 1984
    PubMed
    Summary

    Circadian variation in variant angina is often not clinically obvious but is present. Holter monitoring and ergonovine tests reveal more frequent morning attacks and lower provocation thresholds.

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    Area of Science:

    • Cardiology
    • Circadian Biology
    • Internal Medicine

    Background:

    • Variant angina, a condition characterized by coronary artery spasms, can exhibit temporal patterns.
    • Understanding circadian variations in disease activity is crucial for effective patient management.

    Purpose of the Study:

    • To investigate the presence and extent of circadian variation in disease activity in patients with variant angina.
    • To correlate subjective patient reports with objective electrocardiographic and provocative testing data.

    Main Methods:

    • Continuous Holter electrocardiogram monitoring over 48 hours.
    • Two ergonovine provocation tests administered 12 hours apart (4 AM and 4 PM).
    • Assessment of spontaneous angina attacks and ST-segment abnormalities.

    Main Results:

    • Spontaneous angina episodes were more frequent in the morning (p < 0.02).
    • Holter monitoring revealed significantly more ST elevation and other ischemic changes in the morning (p < 0.05 and p < 0.01).
    • Ergonovine testing showed a lower threshold for inducing spasms in the morning (p < 0.01).

    Conclusions:

    • Circadian variation in variant angina activity is evident in most patients, despite not always being clinically apparent.
    • Objective measures like Holter monitoring and ergonovine tests are more sensitive in detecting these temporal patterns than patient history alone.
    • Morning hours represent a period of increased susceptibility to both spontaneous and provoked coronary artery spasms in variant angina.

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