title: Approximately half of patients with coronary spastic angina had pathologic exercise tests.
abstract: We examined the clinical usefulness of treadmill exercise tests (TETs) in diagnosing coronary spastic angina (CSA).
  
  
  
  We performed the TETs and 24-h Holter monitoring in 300 CSA patients consisting of 152 patients with rest angina, 77 patients with effort angina, and 71 patients with rest and effort angina. Organic stenosis (>75%) was observed in 44 patients. Multiple spasms were recognized in 204 patients (68%).
  
  
  
  Positive TETs were recognized in 113 patients (38%) and borderline was observed in 30 patients (10%). Positive response was significantly higher in patients with organic stenosis than those without fixed stenosis (63.6% vs. 33.2%, p<0.001). Moreover, ST elevation was more frequent in patients with organic stenosis than those without fixed stenosis (27.3% vs. 1.2%, p<0.001). Positive response in patients with effort angina (46.8%) was higher than those in patients with rest angina (33.6%) and rest and effort angina (36.6%), but not significant. Positive response was not different between single spasm and multiple spasms. In all 300 patients, ST segment elevation was observed in only four patients (1.3%) on the 24-h Holter monitoring.
  
  
  
  TET was useful in documenting ischemia in patients with CSA. More than a third of patients with CSA had positive TETs. Moreover, we obtained the pathologic TET response in approximately half of patients with CSA.
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan. Electronic address: EZF03146@nifty.com.
authors.forename: Shozo
authors.initials: S
authors.lastname: Sueda
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Miyoshi
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Sakaue
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Habara
authors.affiliation: Department of Cardiology, Ehime Prefectural Niihama Hospital, Ehime, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kohno
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory / Q000379:methods / Q000706:statistics & numerical data; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity
keywords: Acetylcholine; Coronary spastic angina; Rest angina; Treadmill exercise test