Single vasoreactivity testing has clinical limitations in detecting coronary spasm, suggesting that supplementary or sequential testing should be reconsidered to avoid pseudonegative results.
Does multiple or sequential vasoreactivity testing improve the detection of epicardial and microvascular coronary spasms compared to single testing?
Cardiologists should consider using multiple or sequential vasoreactivity tests in the cardiac catheterization laboratory to overcome the limitations and pseudonegative results of single testing for coronary spasm.
Vasoreactivity testing is used by cardiologists in the diagnosis of coronary spasm endotypes, such as epicardial and microvascular spasm. Intracoronary injection of acetylcholine and ergonovine is defined as a standard class I method according to the Coronary Vasomotion Disorder (COVADIS) Group. Because single vasoreactivity testing may have some clinical limitations in detecting the presence of coronary spasm, supplementary or sequential vasoreactivity testing should be reconsidered. The majority of cardiologists do not consider pseudonegative results when performing these vasoreactivity tests. Vasoreactivity testing may have some limitations when it comes to documenting clinical spasm. In the future, cardiologists around the world should use multiple vasoreactivity tests to verify the presence or absence of epicardial and microvascular spasms in the cardiac catheterisation laboratory.
Sueda et al. (Wed,) conducted a review in Coronary spasm endotypes (epicardial and microvascular spasm). Vasoreactivity testing (intracoronary injection of acetylcholine and ergonovine) was evaluated. Single vasoreactivity testing has clinical limitations in detecting coronary spasm, suggesting that supplementary or sequential testing should be reconsidered to avoid pseudonegative results.