It has been shown in different groups of patients with variant angina that coronary spasm can be reproduced by physiologic maneuvers Received Feb. 4, 1986; revision accepted Aug. 14, 1986. Presented in part at the 58th Scientific Sessions of the American Heart Association, November 11-14, 1985, Washington, D.C.Vol. 74, No. 6, December 1986 In patients with variant angina focal coronary spasm can be reproduced by ergonovine"922 and, less frequently, also by hyperventilation.2"25 Isolated reports suggest that coronary spasm can also be provoked by a number of physiologic maneuvers2"29 and pharmacologic agents such as histamine,9 epinephrine,3 metacholine,5 and dopamine.30 It has therefore become apparent in patients with variant angina that particular segments of their epicardial coronary arteries exhibit an abnormal reactivity to stimuli that produce only minor degrees of coronary constriction, if any, in normal individuals or in patients with other forms of angina.3'The aim of our study was to investigate whether the abnormal coronary reactivity exhibited by patients with vasospastic angina results from specific abnormal agonist-receptor interactions or from a local, nonspecific supersensitivity to different stimuli. To this end, we studied the responses of patients with vasospastic angina to a series of provocative tests known to induce coronary spasm through different mechanisms.

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