Time-related decrease in sensitivity to ergonovine in patients with variant angina.
Eighteen patients with variant angina, a positive ergonovine test, and a favorable response to calcium antagonists were studied by serial ergonovine tests and Holter monitoring to assess the long-term changes in response to ergonovine and the relationship with the spontaneous activity of the disease. The number of patients with a positive test decreased from 18 of 18 in the acute phase to 12 of 18 (66%) at 3 months, 10 of 17 (59%) at 6 months, and five of 17 (29%) at 12 months. The mean dose level of ergonovine associated with a positive response and the percentage of positive tests with ST segment depression increased progressively during follow-up. The results of the ergonovine test were well correlated with the spontaneous activity of the disease in 94%, 83%, 76%, and 71% of the patients at initial observation and at 3, 6 and 12 months, respectively. Thus in patients with variant angina and a favorable response to calcium antagonists, a time-related decrease in sensitivity to ergonovine develops during follow-up. In most patients the response to ergonovine is well correlated with the spontaneous activity of the disease; thus the ergonovine test may be a useful tool in the assessment of the natural evolution of vasospastic angina.
Previtali
M
M
Department of Internal Medicine, University of Pavia, Italy.
Panciroli
C
C
De Ponti
R
R
Chimienti
M
M
Montemartini
C
C
Salerno
J A
JA
D000328:Adult; D000368:Aged; D000788:Angina Pectoris, Variant / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004361:Drug Tolerance; D004562:Electrocardiography; D004874:Ergonovine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D004874:Ergonovine