301. 130 Sublingual nitrates should be used systematically before multislices computered coronary imaging
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Ahmed Fareed, Gérard Haquin, Jean Marc Pernes, Valérie Huart, Jean Claude Gaux, Ramon Labbe, Patrick Dupouy, Maher Hakim, and Mario Auguste
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Mean diameter ,medicine.medical_specialty ,Coronary imaging ,business.industry ,Blood pressure ,medicine.anatomical_structure ,Anesthesia ,Imaging quality ,Internal medicine ,Heart rate ,Cardiology ,medicine ,Cardiology and Cardiovascular Medicine ,business ,Hemodynamic effects ,Artery - Abstract
BackgroundCoronary multislices CT (MDCT) has limited spatial and temporal resolution, which hampered the analysis of coronary artery (CA) segments. By increasing CA geometry the use of nitrates before acquisition could improve analysis quality, which is heart rate (HR) highly dependant.ObjectiveThe aim of this study was to evaluate safety, hemodynamic effects and imaging efficacy of systematic use of sublingual nitroglycerin just before a 256 slices CA scanner acquisition.MethodThirty six consecutive patients had a coronary MDCT acquisition after 1 spray of sublingual nitroglycerin (NatisprayR 0.30mg) (group 1). HR and mean arterial blood pressure (MBP) were measured before and after spray. Global imaging quality assessment, number of analyzable segments according to the syntax score segmentation, mean diameter and area of each segments was done by two blinded observers and compared to a control group of 36 consecutive patients (group 2) examined with the same machine, but without nitrates.ResultsBoth groups were similar considering age, sex ratio, BMI and beta-blocker used. In group 1 nitrates did not change heart rate (62±5 vs. 61±4bpm) nor MBP (100.7±15mmHg vs. 94.9±12mmHg). A total of 536 and 531 segments were analyzed respectively in group 1 and 2. Global imaging quality assessment was equal in both groups (good quality: 93.1% vs. 91.7%, group 1 and 2 respectively). There was
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