医学
激发试验
麦角新碱
冠状动脉痉挛
心绞痛
血管痉挛
心脏病学
金标准(测试)
重症监护医学
血管痉挛性心绞痛
内科学
诊断试验
病理
急诊医学
替代医学
心肌梗塞
蛛网膜下腔出血
作者
Rajan Rehan,John F. Beltrame,A. Yong
标识
DOI:10.1016/j.jjcc.2023.07.020
摘要
Coronary provocation testing is an essential diagnostic procedure when evaluating vasospastic angina. Invasive methods using acetylcholine or ergonovine are considered the current gold standard. Despite efforts from global cardiovascular institutions, current protocols vary in dosage, administration time, and procedural approach. In addition, concerns over the specificity of findings and potential complications have limited routine uptake of this procedure in clinical practice. This systematic review evaluates current diagnostic protocols, focusing on invasive provocation testing. We included studies using intracoronary provocation testing with acetylcholine or ergonovine for the assessment of coronary artery vasospasm that detailed specific elements of the procedure (dosage, administration time, etc.) and included ≥50 patients. A total of 28 articles met strict inclusion criteria. Our review highlights the heterogeneity between current diagnostic protocols for invasive provocation testing. We believe standardization of a diagnostic protocol will encourage both current and future cardiologists to incorporate such procedures in the evaluation of variant angina.
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