Istituto di Fisiologia Clinica     
Pepe A., Lombardi M., Takacs I., Positano V., Panzarella G., Picano E. Nitrate-Induced Coronary Vasodilation by Stress- Magnetic Resonance Imaging: A Novel Noninvasive Test of Coronary Vasomotion. In: JOURNAL OF MAGNETIC RESONANCE IMAGING, vol. 20 pp. 390 - 394. Wiley-Liss, Inc, 2004.
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 con?ned 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, shortaxis 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 ?ve 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.
URL: http://www.interscience.wiley.com
Subject magnetic resonance angiography

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