Beschreibung:
<jats:sec><jats:title>Purpose</jats:title><jats:p>To systematically investigate the effect of sublingual glyceryl trinitrate (nitroglycerin=nitro=glyceryl trinitrate=GTN=C<jats:sub>3</jats:sub>H<jats:sub>5</jats:sub>N<jats:sub>3</jats:sub>O<jats:sub>9</jats:sub> [NTG]) on the diagnostic performance of MR coronary artery imaging (MRCA) to detect relevant coronary artery disease (CAD).</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>Thirty‐five healthy volunteers and 25 patients with suspected or proven CAD (all in sinus rhythm) underwent MRCA before and after NTG using a contrast‐agent free, three‐dimensional, navigator‐based, steady state free precession acquisition (voxel size 1.0 × 0.7 × 0.7 mm<jats:sup>3</jats:sup>) at 1.5 Tesla. Target parameters were stenosis detection (>50%), visible vessel length (straightened planar reconstruction) and vessel diameter (curved planar reconstruction, measured proximal/medial/distal). In patients, invasive coronary angiography served as reference.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>NTG led to increase of the coronary diameter both in healthy volunteers (right coronary artery [RCA]: 3.2 to 3.7 mm, <jats:italic>P</jats:italic> < 0.001; left anterior descending coronary artery [LAD]: 2.9 to 3.4 mm, <jats:italic>P</jats:italic> = 0.009; left circumflex coronary artery [LCx]: 2.8 to 3.3 mm, <jats:italic>P</jats:italic> < 0.001) and patients (RCA 3.5 to 4.0 mm, <jats:italic>P</jats:italic> = 0.01; LAD 3.3 to 3.7 mm, <jats:italic>P</jats:italic> = 0.008; LCx: 2.9 to 3.3 mm, <jats:italic>P</jats:italic> = 0.03). Visible vessel length increased after NTG for the LAD (volunteers: 72 to 84 mm, <jats:italic>P</jats:italic> = 0.03; patients: 56 to 78 mm, <jats:italic>P</jats:italic> = 0.01) and for LCx (volunteers: 48 to 60 mm, <jats:italic>P</jats:italic> = 0.02). Sensitivity to detect > 50% stenosis improved after NTG from 88.0 to 96%, specificity from 46.5 to 69.8%, diagnostic accuracy from 61.8 to 79.4% and positive/negative predictive value from 48.9 to 64.9% and 87.0 to 96.8%, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Sublingual administration of NTG significantly enhanced the visibility of the coronary arteries and improved the detection of coronary artery stenosis.</jats:p><jats:p><jats:bold>Level of Evidence</jats:bold>: 2</jats:p><jats:p>J. MAGN. RESON. IMAGING 2017;45:1419–1428</jats:p></jats:sec>