Coronary vasodilation by the use of sublingual nitroglycerin using 64-slice dual-source coronary computed tomography angiography

Abstract

Sublingual nitroglycerin significantly enlarged the coronary diameters, especially in peripheral small coronary arteries, and increased the evaluable number of coronary segments on coronary CTA.

Sublingual Nitroglycerin Administration in Coronary Computed Tomography Angiography: a Systematic Review

“…Klass et al [ 22 ] showed that the relative vessel diameter increase is larger in distal segments compared to proximal segments. Okada et al [ 25 ] and Sato et al [ 23 ] confirmed this observation for peripheral segments. Kang et al [ 18 ] found a relative increase in diameter in two patients who underwent CCTA with and without administration of nitroglycerin.…”

“… 0.8 3 ✓ ✓ Sato, 2009 [ 23 ] 16-slice Randomized 60 100 70 0.3 ? ✓ ✓ ✓ Lee, 2011 [ 24 ] 64-slice Retrospective 67 100 61 0.6 5 ✓ ✓ ✓ Okada, 2014 [ 25 ] 64-slice DSCT Intra-individual 52 0 71 0.3 4 ✓ ✓ ✓ ✓ HR heart rate; bpm beats per minute; SNG sublingual nitroglycerin; + Korean language; # in tablet form; ° reported for overall study population, if only reported by group, then the group receiving nitroglycerin is reported; ^ β-blockers administered if HR > 65 bpm; ^^ β-blockers administered if HR > 70 bpm …”

“…Seven studies evaluated the effect of sublingual nitroglycerin on coronary diameter on CCTA. Two studies used a randomized design [ 20 , 23 ], one used intra-individual comparison [ 17 , 25 ], one used a matched design [ 22 ] and two used a retrospective review of their database [ 18 , 24 ]. All studies demonstrated an overall increase in diameter with the use of nitroglycerin, ranging from 8 to 30 % (Table 2 ).…”

“…Six CCTA studies evaluated the effect of sublingual nitroglycerin on the number of evaluable segments/branches [ 18 – 20 , 23 – 25 ]. All studies showed an improvement in the number of evaluable segments in the nitroglycerin group.…”

“…All studies showed an improvement in the number of evaluable segments in the nitroglycerin group. Okada et al [ 25 ] observed a non-significant increase in their intra-individual comparison in 52 patients. The effect was particularly profound when only comparing the number of side branches, as was performed by Decramer et al [ 20 ].…”