Abstract
Thirteen hospitalized patients with variant angina were studied to assess circadian variation in disease activity. Over 48 hours, all angina attacks were noted, a continuous Holter electrocardiogram was recorded and 2 ergonovine tests were performed 12 hours apart, 1 at 4 am and the other at 4 pm. Only 2 patients gave a clearcut history of more frequent nocturnal or early morning attacks. During the study period, 1.8 ± 1.6 am and 0.62 ± 1.2 pm angina episodes per patient were reported (p < 0.02), but a circadian pattern was apparent in only 4 patients. However, Holter analysis revealed 5.3 ± 13.8 am and 2.6 ± 8.5 pm episodes of ST elevation per patient (p < 0.05) and 8.1 ± 13.9 am and 3.2 ± 8.5 pm episodes of ST elevation, ST depression or T-wave pseudonormalization (p < 0.01). Ten of 11 patients with Holter abnormalities had more frequent am than pm attacks (p < 0.01). ST elevation developed during all 13 of the 4-AM and 12 of 13 of the 4-PM ergonovine tests. In 10 cases the ergonovine threshold at which the attack occurred was lower in the morning, in no case was it lower in the afternoon, and in 3 patients the morning and afternoon doses were identical (p < 0.01). Thus, circadian variation in disease activity both for spontaneous and provoked attacks is present in most patients with variant angina, even though it is often not clinically apparent.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 61-64 |
| Number of pages | 4 |
| Journal | The American Journal of Cardiology |
| Volume | 54 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 1 1984 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Circadian variation in variant angina. / Waters, David D.; Miller, Donald D; Bouchard, Alain; Bosch, Xavier; Theroux, Pierre.
In: The American Journal of Cardiology, Vol. 54, No. 1, 01.07.1984, p. 61-64.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Circadian variation in variant angina
AU - Waters, David D.
AU - Miller, Donald D
AU - Bouchard, Alain
AU - Bosch, Xavier
AU - Theroux, Pierre
PY - 1984/7/1
Y1 - 1984/7/1
N2 - Thirteen hospitalized patients with variant angina were studied to assess circadian variation in disease activity. Over 48 hours, all angina attacks were noted, a continuous Holter electrocardiogram was recorded and 2 ergonovine tests were performed 12 hours apart, 1 at 4 am and the other at 4 pm. Only 2 patients gave a clearcut history of more frequent nocturnal or early morning attacks. During the study period, 1.8 ± 1.6 am and 0.62 ± 1.2 pm angina episodes per patient were reported (p < 0.02), but a circadian pattern was apparent in only 4 patients. However, Holter analysis revealed 5.3 ± 13.8 am and 2.6 ± 8.5 pm episodes of ST elevation per patient (p < 0.05) and 8.1 ± 13.9 am and 3.2 ± 8.5 pm episodes of ST elevation, ST depression or T-wave pseudonormalization (p < 0.01). Ten of 11 patients with Holter abnormalities had more frequent am than pm attacks (p < 0.01). ST elevation developed during all 13 of the 4-AM and 12 of 13 of the 4-PM ergonovine tests. In 10 cases the ergonovine threshold at which the attack occurred was lower in the morning, in no case was it lower in the afternoon, and in 3 patients the morning and afternoon doses were identical (p < 0.01). Thus, circadian variation in disease activity both for spontaneous and provoked attacks is present in most patients with variant angina, even though it is often not clinically apparent.
AB - Thirteen hospitalized patients with variant angina were studied to assess circadian variation in disease activity. Over 48 hours, all angina attacks were noted, a continuous Holter electrocardiogram was recorded and 2 ergonovine tests were performed 12 hours apart, 1 at 4 am and the other at 4 pm. Only 2 patients gave a clearcut history of more frequent nocturnal or early morning attacks. During the study period, 1.8 ± 1.6 am and 0.62 ± 1.2 pm angina episodes per patient were reported (p < 0.02), but a circadian pattern was apparent in only 4 patients. However, Holter analysis revealed 5.3 ± 13.8 am and 2.6 ± 8.5 pm episodes of ST elevation per patient (p < 0.05) and 8.1 ± 13.9 am and 3.2 ± 8.5 pm episodes of ST elevation, ST depression or T-wave pseudonormalization (p < 0.01). Ten of 11 patients with Holter abnormalities had more frequent am than pm attacks (p < 0.01). ST elevation developed during all 13 of the 4-AM and 12 of 13 of the 4-PM ergonovine tests. In 10 cases the ergonovine threshold at which the attack occurred was lower in the morning, in no case was it lower in the afternoon, and in 3 patients the morning and afternoon doses were identical (p < 0.01). Thus, circadian variation in disease activity both for spontaneous and provoked attacks is present in most patients with variant angina, even though it is often not clinically apparent.
UR - http://www.scopus.com/inward/record.url?scp=0021266862&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0021266862&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(84)90304-7
DO - 10.1016/0002-9149(84)90304-7
M3 - Article
C2 - 6741840
AN - SCOPUS:0021266862
VL - 54
SP - 61
EP - 64
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 1
ER -