Diagnosis of vasospastic angina by hyperventilation and cold-pressor stress echocardiography: Comparison to 123I-MIBG myocardial scintigraphy

Hirano, Yutaka; Ozasa, Yoshihisa; Yamamoto, Tohru; Nakagawa, Kizuku; Uehara, Hisakazu; Yamada, Satoru; Itoh, Hiroshi; Ishikawa, Kinji

doi:10.1067/mje.2002.118033

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Furthermore, emergent invasive cardiac catheterization must be available on site in case of refractory coronary spasm requiring coronary intervention. However, similar test settings were previously reported using nuclear perfusion imaging and echocardiography as imaging techniques without complications (8,9).…”

Section: Discussionsupporting

confidence: 51%

“…However, the precise cellular and molecular mechanisms of coronary vasospasm are still unknown (7). Previously, myocardial scintigraphy has been studied in order to non-invasively detect coronary vasospasm (8,9). However, apart from using ionizing radiation, the disadvantages of scintigraphic techniques include limited functional evaluation and in-plane-resolution, respectively.…”

Section: Introductionmentioning

confidence: 98%

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Non-Invasive Evaluation of Coronary Vasospasm Using a Combined Hyperventilation and Cold-Pressure-Test Perfusion CMR Protocol

Yılmaz

Mahrholdt

Athanasiadis

et al. 2007

J. of Cardiovascular Magnetic Resonance

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Coronary vasospasm is a severe vasoconstriction of an epicardial coronary artery, which may lead to myocardial ischemia and cause symptoms of angina. The gold-standard for diagnosing coronary vasospasm is to perform an intracoronary provocation test and to demonstrate the epicardial vasoconstriction by coronary angiography. We report the case of a patient with coronary vasospasm in whom we succeeded to non-invasively provoke and subsequently non-invasively demonstrate myocardial ischemia by perfusion cardiovascular magnetic resonance (CMR).

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 98%

Non-Invasive Evaluation of Coronary Vasospasm Using a Combined Hyperventilation and Cold-Pressure-Test Perfusion CMR Protocol

Yılmaz

Mahrholdt

Athanasiadis

et al. 2007

J. of Cardiovascular Magnetic Resonance

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“…More recently, reports were published concerning CPT provocation complementary with echocardiographic or scintigraphic imaging of wall motion abnormalities or defects for the detection of ischemia related to coronary spasm [6]. In our patient, CPT proved useful and sufficient enough to reveal not only ischemia but also ischemia induced ventricular arrhythmias and therefore, to clarify the etiology of syncope.…”

Section: Discussionmentioning

confidence: 88%

Complex arrhythmias in Prinzmetal's angina reproduced by cold pressor test

Manolis¹,

Akridas²,

Chatzis³

et al. 2010

International Journal of Cardiology

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“…In this analysis, three studies combined cold pressor stress with HVT. Some authors suggest that combining cold‐pressor with HVT raises the occurrence of coronary spasm 49,59,66 . The pooled sensitivity of studies combining HVT with cold‐pressor stress was superior (93%, 95% CI: 83%–97%) to those with HVT alone (80%, 95% CI: 45%–95%); however, the broad and overlapping CI precludes drawing definitive conclusions.…”

Section: Discussionmentioning

confidence: 99%

Hyperventilation testing in the diagnosis of vasospastic angina: A clinical review and meta‐analysis

Boivin‐Proulx,

Marquis‐Gravel,

Rousseau‐Saine

et al. 2024

Eur J Clin Investigation

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BackgroundGiven the limited access to invasive vasospastic reactivity testing in Western Countries, there is a need to further develop alternative non‐invasive diagnostic methods for vasospastic angina (VSA). Hyperventilation testing (HVT) is defined as a class IIa recommendation to diagnose VSA by the Japanese Society of Cardiology.MethodsIn this systematic review and meta‐analysis reported according to the PRISMA statement, we review the mechanisms, methods, modalities and diagnostic accuracy of non‐invasive HVT for the diagnostic of VSA.ResultsA total of 106 articles published between 1980 and 2022 about VSA and HVT were included in the systematic review, among which 16 were included in the meta‐analysis for diagnostic accuracy. Twelve electrocardiogram‐HVT studies including 804 patients showed a pooled sensitivity of 54% (95% confidence intervals [CI]; 30%–76%) and a pooled specificity of 99% (95% CI; 88%–100%). Four transthoracic echocardiography‐HVT studies including 197 patients revealed a pooled sensitivity of 90% (95% CI; 82%–94%) and a pooled specificity of 98% (95% CI; 86%–100%). Six myocardial perfusion imaging‐HVT studies including 112 patients yielded a pooled sensitivity of 95% (95% CI; 63%–100%) and a pooled specificity of 78% (95% CI; 19%–98%). Non‐invasive HVT resulted in a low rate of adverse events, ventricular arrhythmias being the most frequently reported, and were resolved with the administration of nitroglycerin.ConclusionsNon‐invasive HVT offers a safe alternative with high diagnostic accuracy to diagnose VSA in patients with otherwise undiagnosed causes of chest pain.

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Diagnosis of vasospastic angina by hyperventilation and cold-pressor stress echocardiography: Comparison to 123I-MIBG myocardial scintigraphy

Cited by 15 publications

References 26 publications

Non-Invasive Evaluation of Coronary Vasospasm Using a Combined Hyperventilation and Cold-Pressure-Test Perfusion CMR Protocol

Non-Invasive Evaluation of Coronary Vasospasm Using a Combined Hyperventilation and Cold-Pressure-Test Perfusion CMR Protocol

Complex arrhythmias in Prinzmetal's angina reproduced by cold pressor test

Hyperventilation testing in the diagnosis of vasospastic angina: A clinical review and meta‐analysis

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