Impaired Coronary Vasodilation by Magnetic Resonance Angiography Is Associated With Advanced Coronary Artery Calcification
Masahiro Terashima, MD, PhD, FACC*,
Patricia K. Nguyen, MD*,
Geoffrey D. Rubin, MD ,
Carlos Iribarren, MD, MPH, PhD ,
Brian K. Courtney, MD*,
Alan S. Go, MD,||,
Stephen P. Fortmann, MD ,
Michael V. McConnell, MD, MSEE, FACC*,*
* Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
Department of Radiology, Stanford University School of Medicine, Stanford, California
Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California
Division of Research, Kaiser Permanente of Northern California, Oakland, California
|| Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco, San Francisco, California.
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Figure 1 Coronary MRA of NTG-Induced Coronary Vasodilation
Coronary magnetic resonance angiography (MRA) images are shown demonstrating the analysis of nitroglycerin (NTG)-induced vasodilation. Coronary MRA of the right coronary artery (RCA) was performed pre- and post-NTG using a 0.7-mm gated, breath-held spiral MRA sequence. Cross-sectional area of the RCA was traced manually (red circles). The MRA images (A) from the patient with a coronary artery calcium (CAC) score = 0 show a greater degree of NTG coronary vasodilation (28.6%) compared with MRA images (B) from the patient with a CAC score = 443 (coronary vasodilation = 17.0%).
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Figure 2 Comparison of NTG-Induced Coronary Vasodilation and CAC
The degree of coronary vasodilation is shown for patients with and without advanced CAC. Coronary MRA images were analyzed in 212 patients and coronary vasodilation to NTG was quantified. Coronary artery calcium scoring was performed by computed tomography. Box and whisker plots show the median, interquartile range, and full range of percent coronary vasodilation between groups with and without advanced CAC ( 400). Patients with CAC 400 had significantly impaired NTG-induced coronary vasodilation compared to patients with CAC <400 by univariate and multivariate analysis (p = 0.02). Abbreviations as in Figure 1.
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