Details

Autor(en) / Beteiligte

• Heer, Tobias
• Reiter, Stephanie
• Trißler, Markus
• Höfling, Berthold
• von Knobelsdorff‐Brenkenhoff, Florian
• Pilz, Günter

Titel

Effect of Nitroglycerin on the Performance of MR Coronary Angiography

Ist Teil von

• Journal of magnetic resonance imaging, 2017-05, Vol.45 (5), p.1419-1428

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Purpose To systematically investigate the effect of sublingual glyceryl trinitrate (nitroglycerin=nitro=glyceryl trinitrate=GTN=C3H5N3O9 [NTG]) on the diagnostic performance of MR coronary artery imaging (MRCA) to detect relevant coronary artery disease (CAD). Materials and Methods Thirty‐five healthy volunteers and 25 patients with suspected or proven CAD (all in sinus rhythm) underwent MRCA before and after NTG using a contrast‐agent free, three‐dimensional, navigator‐based, steady state free precession acquisition (voxel size 1.0 × 0.7 × 0.7 mm3) at 1.5 Tesla. Target parameters were stenosis detection (>50%), visible vessel length (straightened planar reconstruction) and vessel diameter (curved planar reconstruction, measured proximal/medial/distal). In patients, invasive coronary angiography served as reference. Results NTG led to increase of the coronary diameter both in healthy volunteers (right coronary artery [RCA]: 3.2 to 3.7 mm, P < 0.001; left anterior descending coronary artery [LAD]: 2.9 to 3.4 mm, P = 0.009; left circumflex coronary artery [LCx]: 2.8 to 3.3 mm, P < 0.001) and patients (RCA 3.5 to 4.0 mm, P = 0.01; LAD 3.3 to 3.7 mm, P = 0.008; LCx: 2.9 to 3.3 mm, P = 0.03). Visible vessel length increased after NTG for the LAD (volunteers: 72 to 84 mm, P = 0.03; patients: 56 to 78 mm, P = 0.01) and for LCx (volunteers: 48 to 60 mm, P = 0.02). Sensitivity to detect > 50% stenosis improved after NTG from 88.0 to 96%, specificity from 46.5 to 69.8%, diagnostic accuracy from 61.8 to 79.4% and positive/negative predictive value from 48.9 to 64.9% and 87.0 to 96.8%, respectively. Conclusion Sublingual administration of NTG significantly enhanced the visibility of the coronary arteries and improved the detection of coronary artery stenosis. Level of Evidence: 2 J. MAGN. RESON. IMAGING 2017;45:1419–1428