TY - JOUR
T1 - Using multidetector computed tomography in a swine model to assess the effects of sublingual nitroglycerin and intravenous adenosine on epicardial coronary arteries
AU - Clarkson, Wesley A.
AU - Restrepo, Carlos Santiago
AU - Bauch, Terry D.
AU - Rubal, Bernard J.
PY - 2009/12
Y1 - 2009/12
N2 - This study examines the effects of intravenous infusion of adenosine and sublingual nitroglycerin on coronary angiograms obtained by current-generation multidetector computed tomography. We assessed coronary vasodilation at baseline and after intravenous adenosine (140 μg/kg/min) or sublingual nitroglycerin spray (800 μg) in 7 female swine (weight, 40.9 ±1.4 kg) by using electrocardiogram-gated coronary angiography with a 64-detector scanner (rotation time, 400 ms; 120kV; 400 mA) and intravenous contrast (300 mg/mL iohexol, 4.5 mL/s, 2 mL/kg). Cross-sectional areas of segments in the left anterior descending, circumflex, and right coronary arteries were evaluated in oblique orthogonal views. Images were acquired at an average heart rate of 73 ± 11 beats per minute. Changes in aortic pressure were not significant with nitroglycerin but decreased (approximately 10%) with adenosine. Of the 76 segments analyzed (baseline range, 2 to 39 mm2), 1 distal segment could not be assessed after adenosine. Segment cross-sectional area increased by 11.3% with nitroglycerin but decreased by 9.6% during adenosine infusion. The results of the present study are consistent with the practice of using sublingual nitroglycerin to enhance visualization of epicardial vessels and suggest that intravenous adenosine may hinder coronary artery visualization. This study is the first repeated-measures electrocardiogram-gated CT evaluation to use the same imaging technology to assess changes in coronary cross-sectional area before and after treatment with a vasodilator. The nitroglycerin- associated changes in our swine model were modest in comparison with previously reported human studies.
AB - This study examines the effects of intravenous infusion of adenosine and sublingual nitroglycerin on coronary angiograms obtained by current-generation multidetector computed tomography. We assessed coronary vasodilation at baseline and after intravenous adenosine (140 μg/kg/min) or sublingual nitroglycerin spray (800 μg) in 7 female swine (weight, 40.9 ±1.4 kg) by using electrocardiogram-gated coronary angiography with a 64-detector scanner (rotation time, 400 ms; 120kV; 400 mA) and intravenous contrast (300 mg/mL iohexol, 4.5 mL/s, 2 mL/kg). Cross-sectional areas of segments in the left anterior descending, circumflex, and right coronary arteries were evaluated in oblique orthogonal views. Images were acquired at an average heart rate of 73 ± 11 beats per minute. Changes in aortic pressure were not significant with nitroglycerin but decreased (approximately 10%) with adenosine. Of the 76 segments analyzed (baseline range, 2 to 39 mm2), 1 distal segment could not be assessed after adenosine. Segment cross-sectional area increased by 11.3% with nitroglycerin but decreased by 9.6% during adenosine infusion. The results of the present study are consistent with the practice of using sublingual nitroglycerin to enhance visualization of epicardial vessels and suggest that intravenous adenosine may hinder coronary artery visualization. This study is the first repeated-measures electrocardiogram-gated CT evaluation to use the same imaging technology to assess changes in coronary cross-sectional area before and after treatment with a vasodilator. The nitroglycerin- associated changes in our swine model were modest in comparison with previously reported human studies.
UR - http://www.scopus.com/inward/record.url?scp=76049091400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76049091400&partnerID=8YFLogxK
M3 - Article
C2 - 20034433
AN - SCOPUS:76049091400
VL - 59
SP - 573
EP - 579
JO - Comparative Medicine
JF - Comparative Medicine
SN - 1532-0820
IS - 6
ER -