PURPOSE: To evaluate the feasibility of assessing coronary vasodilation following exogenous nitrates, using magnetic resonance angiography (MRA). The assessment of coronary response to exogenous nitrovasodilators may have a diagnostic and prognostic impact in patients with coronary artery disease. To date, stress imaging of coronary artery vasomotion has been confined to the catheterization laboratory. MRA is emerging as a noninvasive tool for coronary artery imaging. MATERIALS AND METHODS: Coronary MRA was performed in 20 healthy volunteers (12 males, age = 33 +/- 8). We used spiral spoiled gradient echo (SSGE) sequences for imaging of coronary artery lumen. After the baseline short-axis view of the coronary artery was obtained, sublingual nitroglycerin (NTG) (0.3 mg) was administered. In all subjects, short-axis views of the coronary artery were acquired repetitively (8-10 times) from 1 up to 10 minutes after NTG administration. Measurements were obtained by two independent investigators. RESULTS: Interpretable short-axis view of left anterior descending artery (LAD) was obtained in 15 subjects (75%); in the remaining five subjects the right coronary artery (RCA) was examined. The interobserver variability was 15%, and the intraobserver variability 4%. The NTG-induced maximal vasodilation was 43 +/- 22%. The vasodilator response over time after NTG was maximal on average at 279 +/- 112 seconds, but with substantial heterogeneity. CONCLUSION: Entity and time course of nitrate-induced coronary vasodilation in the left anterior descending and/or RCA can be assessed using MRA with high feasibility and reproducibility. Coronary MRA has potential for dynamic imaging of coronary vasomotion.
Nitrate-induced coronary vasodilation by stress-magnetic resonance imaging: a novel noninvasive test of coronary vasomotion
Pepe A;
2004
Abstract
PURPOSE: To evaluate the feasibility of assessing coronary vasodilation following exogenous nitrates, using magnetic resonance angiography (MRA). The assessment of coronary response to exogenous nitrovasodilators may have a diagnostic and prognostic impact in patients with coronary artery disease. To date, stress imaging of coronary artery vasomotion has been confined to the catheterization laboratory. MRA is emerging as a noninvasive tool for coronary artery imaging. MATERIALS AND METHODS: Coronary MRA was performed in 20 healthy volunteers (12 males, age = 33 +/- 8). We used spiral spoiled gradient echo (SSGE) sequences for imaging of coronary artery lumen. After the baseline short-axis view of the coronary artery was obtained, sublingual nitroglycerin (NTG) (0.3 mg) was administered. In all subjects, short-axis views of the coronary artery were acquired repetitively (8-10 times) from 1 up to 10 minutes after NTG administration. Measurements were obtained by two independent investigators. RESULTS: Interpretable short-axis view of left anterior descending artery (LAD) was obtained in 15 subjects (75%); in the remaining five subjects the right coronary artery (RCA) was examined. The interobserver variability was 15%, and the intraobserver variability 4%. The NTG-induced maximal vasodilation was 43 +/- 22%. The vasodilator response over time after NTG was maximal on average at 279 +/- 112 seconds, but with substantial heterogeneity. CONCLUSION: Entity and time course of nitrate-induced coronary vasodilation in the left anterior descending and/or RCA can be assessed using MRA with high feasibility and reproducibility. Coronary MRA has potential for dynamic imaging of coronary vasomotion.
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