The Department of Cardiology, the Second Affiliated Hospital of Nantong University, No. 6, Hai'er Xiang North Road, Chongchuan District, Nantong, 226001, China.
Sci Rep. 2021 Feb 12;11(1):3767. doi: 10.1038/s41598-021-83356-0.
We investigated the sensitivity, specificity and safety of ergonovine provocation test of radial artery in the diagnosis of coronary artery spasm (CAS). The patients who came to our hospital for chest pain from January to June 2020 as well as had coronary stenosis < 50% and no radial artery stenosis, were enrolled in this study. These patients were divided into CAS group and control group after intracoronary ergonovine provocation test. All patients underwent ergonovine provocation test of radial artery, the inner diameter (D and D) and the peak systolic velocities (PSV and PSV) of the radial artery were measured by ultrasound before and after ergonovine provocation. The predictive value of ergonovine provocation test of radial artery for the diagnosis of CAS was analyzed using receiver operator characteristic (ROC) curve. There were 19 patients in the CAS group and 28 patients in the control group. Low density lipoprotein cholesterol and smoking rate were significantly higher in the CAS group than in the control group (all P < 0.05), but there were no significant differences in other items (P > 0.05) between the two groups. In the ergonovine provocation test of radial artery, degree of radial artery stenosis was significantly higher in the CAS group [41.50% (35.60%, 50.00%)] than in the control group [11.25% (5.15%, 23.00%)] (P = 0.000), but there were no siginificant differences in D, PSV and PSV between the two groups (P > 0.05). The area under ROC curve of ergonovine (120 µg) provocation test of radial artery for the diagnosis of CAS was 0.912 with 95%CI: 0.792-0.975, P = 0.001, cut-off of 31%, specificity of 92.86% and sensitivity of 84.21%. The ergonovine (120 µg) provocation test of radial artery did not cause any adverse reactions. We concluded that the ergonovine provocation test of radial artery has high sensitivity, specificity and safety in the diagnosis of CAS.
我们研究了桡动脉麦角新碱激发试验诊断冠状动脉痉挛（CAS）的敏感性、特异性和安全性。入选 2020 年 1 月至 6 月因胸痛就诊我院且冠状动脉狭窄<50%且无桡动脉狭窄的患者，行冠状动脉内麦角新碱激发试验后分为 CAS 组和对照组。所有患者均行经桡动脉麦角新碱激发试验，超声测量麦角新碱激发试验前后桡动脉内径（D 和 D）和收缩期峰值流速（PSV 和 PSV）。采用受试者工作特征（ROC）曲线分析桡动脉麦角新碱激发试验对 CAS 的诊断价值。CAS 组 19 例，对照组 28 例。CAS 组低密度脂蛋白胆固醇和吸烟率明显高于对照组（均 P<0.05），但两组其他项目比较差异无统计学意义（P>0.05）。桡动脉麦角新碱激发试验中，CAS 组桡动脉狭窄程度[41.50%（35.60%，50.00%）]明显高于对照组[11.25%（5.15%，23.00%）]（P=0.000），但两组 D、PSV 和 PSV 比较差异无统计学意义（P>0.05）。桡动脉麦角新碱（120µg）激发试验诊断 CAS 的 ROC 曲线下面积为 0.912，95%CI：0.792-0.975，P=0.001，最佳截断值为 31%，特异度为 92.86%，敏感度为 84.21%。桡动脉麦角新碱（120µg）激发试验未引起不良反应。结论：桡动脉麦角新碱激发试验诊断 CAS 具有较高的敏感性、特异性和安全性。
