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Impaired coronary vasodilation by magnetic resonance angiography is associated with advanced coronary artery calcification.

Publication ,  Journal Article
Terashima, M; Nguyen, PK; Rubin, GD; Iribarren, C; Courtney, BK; Go, AS; Fortmann, SP; McConnell, MV
Published in: JACC Cardiovasc Imaging
March 2008

OBJECTIVES: This study evaluated the hypothesis that impaired nitroglycerin (NTG)-induced coronary vasodilation is associated with advanced coronary atherosclerosis in asymptomatic older patients. BACKGROUND: Atherosclerosis is associated with both structural and functional abnormalities of the vessel wall. Noninvasive functional measures of subclinical coronary atherosclerosis may help characterize high-risk subjects and guide preventive therapy. METHODS: A total of 236 older patients (age 60 to 72 years, 33% female) without a history of cardiovascular disease were studied. Nitroglycerin-induced coronary vasodilation was measured by magnetic resonance angiography (MRA). Cross-sectional images of the right coronary artery were acquired before and 5 min after 0.4-mg sublingual NTG using a gated, breath-held spiral coronary MRA sequence (0.7-mm resolution). Quantitative analysis of the increase in cross-sectional area was performed in the 90% of patients (n = 212) with adequate image quality. Quantitation of coronary artery calcification (CAC) was performed by multidetector computed tomography using the Agatston method. RESULTS: Forty patients (19%) had advanced CAC (> or =400). Coronary vasodilation to NTG was significantly impaired (p = 0.02) in patients with advanced CAC (median [interquartile range] = 15.9% [4.2% to 28.0%] vs. 21.5% [9.6% to 36.6%] for CAC <400). Importantly, NTG-induced coronary vasodilation remained independently associated with advanced CAC after multivariate analysis incorporating risk factors (p = 0.02) and other potential confounders (p = 0.04). There was no significant difference in coronary vasodilation between men and women, but few women (n = 3) had advanced CAC. CONCLUSIONS: Impaired NTG-induced coronary vasodilation by MRA is associated with advanced coronary atherosclerosis in a community-based cohort of older asymptomatic subjects. Coronary MRA may provide a noninvasive functional assessment of subclinical coronary atherosclerosis.

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Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

March 2008

Volume

1

Issue

2

Start / End Page

167 / 173

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vasodilation
  • Severity of Illness Index
  • Predictive Value of Tests
  • Nitroglycerin
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Image Interpretation, Computer-Assisted
  • Humans
 

Citation

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Terashima, M., Nguyen, P. K., Rubin, G. D., Iribarren, C., Courtney, B. K., Go, A. S., … McConnell, M. V. (2008). Impaired coronary vasodilation by magnetic resonance angiography is associated with advanced coronary artery calcification. JACC Cardiovasc Imaging, 1(2), 167–173. https://doi.org/10.1016/j.jcmg.2007.12.001
Journal cover image

Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

March 2008

Volume

1

Issue

2

Start / End Page

167 / 173

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vasodilation
  • Severity of Illness Index
  • Predictive Value of Tests
  • Nitroglycerin
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Image Interpretation, Computer-Assisted
  • Humans