Hyperventilation Test

  • Eugenio Picano


Hyperventilation tests have been mainly used in clinical practice as a provocative test for coronary artery vasospasm in patients with suspected or documented vasospastic angina [1–4]. The rationale for the use of hyperventilation testing for this purposes is based upon the demonstration that, in susceptible patients, hyperventilation may trigger a vasospasm of a major epicardial coronary artery associated with chest pain and ischemic electrocardiographic changes similar to those observed during spontaneous anginal attacks [1].


Atrial Natriuretic Peptide Coronary Flow Reserve Cold Pressor Test Coronary Artery Spasm Variant Angina 
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  1. 1.
    Yasue H, Nagao M, Omote S, et al (1978) Coronary arterial spasm and Prinzmetal’s variant form of angina induced by hyperventilation and Tris-buffer infusion. Circulation 58:56–62PubMedCrossRefGoogle Scholar
  2. 2.
    Mortensen SA, Vilhelmsen R, Sandoe E (1983) Non-pharmacological provocation of coronary vasospasm. Experience with prolonged hyperventilation in the coronary care unit. Eur Heart J 4:391–397PubMedGoogle Scholar
  3. 3.
    Rasmussen K, Bagger JP, Bottzauw J, et al (1984) Prevalence of vasospastic ischaemia induced by the cold pressor test or hyperventilation in patients with severe angina. Eur Heart J 5:354–361PubMedGoogle Scholar
  4. 4.
    Previtali M, Ardissino D, Barberis P, et al (1989) Hyperventilation and ergonovine tests in Prinzmetal’s variant angina pectoris in men. Am J Cardiol 63:17–20PubMedCrossRefGoogle Scholar
  5. 5.
    Weber S, Pasquier G, Guiomard A, et al (1981) Clinical application of the alkalosis induction test for coronary artery spasm. Arch Mal Coeur Vaiss 74:1389–1395PubMedGoogle Scholar
  6. 6.
    Ardissino D, De Servi S, Falcone C, et al (1987) Role of hypocapnic alkalosis in hyperventila-tion-induced coronary artery spasm in variant angina. Am J Cardiol 59:707–709PubMedCrossRefGoogle Scholar
  7. 7.
    Morales MA, Reisenhofer B, Rovai D, et al (1993) Hyperventilation-echocardiography test for the diagnosis of myocardial ischaemia at rest. Eur Heart J 14:1088–1093PubMedCrossRefGoogle Scholar
  8. 8.
    Girotti LA, Crosatto JR, Messuti H, et al (1982) The hyperventilation test as a method for developing successful therapy in Prinzmetal’s angina. Am J Cardiol 49:834–841PubMedCrossRefGoogle Scholar
  9. 9.
    Kaski JC, Crea F, Meran D, et al (1986) Local coronary supersensitivity to diverse vasoconstrictive stimuli in patients with variant angina. Circulation 74:1255–1265PubMedCrossRefGoogle Scholar
  10. 10.
    Fujii H, Yasue H, Okumura K, et al (1988) Hyperventilation-induced simultaneous multives-sel coronary spasm in patients with variant angina: an echocardiographic and arteriographic study. J Am Coll Cardiol 12:1184–1192PubMedCrossRefGoogle Scholar
  11. 11.
    Maseri A (1996) Variant angina. In: Maseri A (ed) Ischemic heart disease. Churchill Livingston, London, pp 559–588Google Scholar
  12. 12.
    Nakao K, Ohgushi M, Yoshimura M, et al (1997) Hyperventilation as a specific test for diagnosis of coronary artery spasm. Am J Cardiol 80:545–549PubMedCrossRefGoogle Scholar
  13. 13.
    Astarita C, Rumolo S, Liguori E (1999) Syncopal vasospastic angina in a patient with familial nonobstructive hypertrophic cardiomyopathy. G Ital Cardiol 29:159–162PubMedGoogle Scholar
  14. 14.
    Alcala Lopez JE, Azpitarte Almagro J, Alvarez Lopez M, et al (1995) Syncope and chest pain. Demonstration of the mechanism by the hyperventilation test. Rev Esp Cardiol 48:631–633Google Scholar
  15. 15.
    Kawano H, Motoyama T, Hirai N, et al (2001) Estradiol supplementation suppresses hyper-ventilation-induced attacks in postmenopausal women with variant angina. J Am Coll Cardiol 37:735–740PubMedCrossRefGoogle Scholar
  16. 16.
    Tanaka H, Yasue H, Yoshimura M, et al (1993) Suppression of hyperventilation-induced attacks with infusion of atrial natriuretic peptide in patients with variant angina pectoris. Am J Cardiol 72:128–133PubMedCrossRefGoogle Scholar
  17. 17.
    Sueda S, Fukuda H, Watanabe K, et al (2001) Usefulness of accelerated exercise following mild hyperventilation for the induction of coronary artery spasm: comparison with an acetylcholine test. Chest 119:155–162PubMedCrossRefGoogle Scholar
  18. 18.
    Hirano Y, Ozasa Y, Yamamoto T, et al (2001) Hyperventilation and cold-pressor stress echocardiography for noninvasive diagnosis of coronary artery spasm. J Am Soc Echocar-diogr 14:626–633CrossRefGoogle Scholar
  19. 19.
    Hirano Y, Ozasa Y, Yamamoto T, et al (2002) Diagnosis of vasospastic angina by hyperventilation and cold-pressor stress echocardiography: comparison to I-MIBG myocardial scintigraphy. J Am Soc Echocardiogr 15:617–623PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Eugenio Picano
    • 1
  1. 1.Institute of Clinical PhysiologyNational Research CouncilPisaItaly

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