Angiologia: Acesso Aberto
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What Factors Contribute to Chest Symptoms during Exercise in Patients with Vasospastic Angina?

Teragawa H*, Fujii Y, Oshita C, Uchimura Y and Ueda T

Objective: Chest symptoms in patients with vasospastic angina (VSA) typically occur during rest. However, we have occasionally experienced patients with VSA who have had chest symptoms even during exercise. However, factors contributing to the chest symptoms during exercise in patients with VSA remain unclear. Therefore, we investigated this relationship.

Methods: We investigated 101 patients with VSA (mean age: 67 years, 51 males and 50 females). We completed detailed chest symptom examinations at rest (n=85), during exercise (n=2), and both at rest and during exercise (n=14). Patients were divided into the two groups: Group I consisted of patients with VSA whose chest symptoms occurred only at rest (n=85, 84%) and Group II consisted of patients with VSA whose chest symptoms occurred during exercise (n=16, 16%). On a coronary angiography, the presence of atherosclerosis (% stenosis>25%), significant coronary stenosis (% stenosis>50%), and myocardial bridging (MB), defined as the narrowing of the coronary artery during systole, were checked. Clinical parameters, including angiographic findings, were assessed in the two groups.

Results: There were no significant differences in coronary risk factors between the two groups. The presence of atherosclerosis (Group I: 58% vs. group II: 75%) and significant coronary stenosis (Group I: 10% vs. group II: 25%) did not differ between-groups. The presence of MB was significantly higher in Group II (50%) than in Group I (12%, p=0.0002). Logistic regression analysis showed that the presence of MB was associated with patients in Group II.

Conclusions: MB, rather than coronary atherosclerosis or significant coronary stenosis, may contribute to chest symptoms during exercise in patients with VSA.