Noninvasive detection of coronary vasospastic angina using a double-acquisition coronary CT angiography protocol in the presence and absence of an intravenous nitrate: a pilot study

• Published in: European radiology 2017-03, Vol.27 (3), p.1136-1147
• Main Authors: Kang, Eun-Ju, Kim, Moo Hyun, De Jin, Cai, Seo, Jeongmin, Kim, Dong Won, Yoon, Seong Kuk, Park, Tae-Ho, Lee, Ki-Nam, Choi, Sang Il, Yoon, Yeonyee Elizabeth
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Angina pectoris; Angina Pectoris - diagnostic imaging; Angina Pectoris - etiology; Cardiac; Cardiology; Computed Tomography Angiography - methods; Coronary Angiography - methods; Coronary Vasospasm - diagnostic imaging; Coronary vessels; Coronary Vessels - diagnostic imaging; Diagnostic Radiology; Ergonovine; Feasibility Studies; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Nitrates; Patients; Pilot Projects; Prospective Studies; Radiology; Sensitivity and Specificity; Tomography; Tomography, X-Ray Computed; Ultrasound; Vasodilator Agents; Veins & arteries
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-016-4476-2

Objectives To evaluate the feasibility of a double-acquisition coronary CT angiography (CCTA) protocol in the presence and absence of an intravenous (IV) vasodilator infusion for detecting vasospastic angina. Methods Twenty patients with a high clinical probability of vasospastic angina were enrolled. All subjects underwent baseline CCTA without a vasodilator in the early morning followed by a catheterized coronary angiography with ergonovine provocation test. Within 3 days, all subjects underwent repeat CCTA during a continuous IV infusion of nitrate. Vasospastic angina as detected by CCTA was defined as significant stenosis (≥50 %) with negative remodelling without definite plaques or diffuse small diameter (