Evaluation of coronary spasm using coronary CTA with or without administration of nitroglycerin

• Project/Area Number: 24591768
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Yamaguchi University
• Principal Investigator: OKADA Munemasa 山口大学, 医学部附属病院, 講師 (70380003)
• Co-Investigator(Kenkyū-buntansha): MATSUNAGA Naofumi 山口大学, 大学院医学系研究科, 教授 (40157334)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2014: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2013: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2012: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
• Keywords: 心臓CT / 冠動脈 / 冠攣縮 / 亜硝酸薬 / 不安定狭心症 / ニトログリセリン / 冠動脈CT / 冠動脈拡張能 / 血管拡張能 / 冠動脈内皮細胞障害

Outline of Final Research Achievements

The influence of applying nitroglycerin was analyzed about the coronary diameter, coronary luminal attenuation, evaluable number of coronary segments, heart rate (HR) and HR variability, the optimal reconstruction phase and image scoring of CTA in the same patients using 64-slice dual-source CT. Sublingual nitroglycerin significantly enlarged the coronary diameters, especially in peripheral small coronary arteries, and increased the evaluable number of coronary segments on coronary CTA.
The coronary vasodilation was also evaluated based on the plaque characteristics (calcified-, mixed- or non-calcified-plaques) after sublingual nitroglycerin administration using 64-slice dual-source coronary CT angiography. Coronary atherosclerotic plaque were found to decrease the coronary vasodilation regardless of the plaque characteristics.
Coronary vasodilation is also evaluated at each segment based on the clinical significance of spastic angina diagnosed by two cardiologists.

Research Products

• [Journal Article] Coronary vasodilation by the use of sublingual nitroglycerin using 64-slice dual-source coronary computed tomography angiography. (2015)
  • Author(s): Okada M, Nakashima Y, Nomura T, Miura T, Nao T, Yoshimura M, Sano Y, Matsunaga N
  • Journal Title: J Cardiol Volume: 65 Issue: 3 Pages: 230-6
  • DOI: 10.1016/j.jjcc.2014.05.012
  • Peer Reviewed
• [Journal Article] New quantitative method to diagnose coronary in-stent restenosis by 64-multislice computed tomography (2015)
  • Author(s): Yoshimura M, Nao T, Miura T, Okada M, Nakashima Y, Fujimura T, Okamura T, Yamada J, Matsunaga N, Matsuzaki M, Yano M.
  • Journal Title: J Cardiol Volume: 65 Issue: 1 Pages: 57-62
  • DOI: 10.1016/j.jjcc.2014.03.013
  • Peer Reviewed / Open Access
• [Journal Article] Added value of lung perfused blood volume images using dual-energy CT for assessment of acute pulmonary embolism. (2015)
  • Author(s): Okada M, Kunihiro Y, Nakashima Y, Nomura T, Kudomi S, Yonezawa T, Suga K, Matsunaga N.
  • Journal Title: Eur J Radiol Volume: 84 Issue: 1 Pages: 172-7
  • DOI: 10.1016/j.ejrad.2014.09.009
  • Peer Reviewed
• [Journal Article] The effect of the section thickness used for 2- and 3-dimensional quantification of dual-energy perfusion computed tomography. (2014)
  • Author(s): Nomura T, Okada M, Nakashima Y, Yonezawa T, Kudomi S, Kido S, Matsunaga N
  • Journal Title: J Comput Assist Tomogr. Volume: 38 Issue: 6 Pages: 979-84
  • DOI: 10.1097/rct.0000000000000148
  • Peer Reviewed
• [Journal Article] Dual-source computed tomography coronary angiography in patients with high heart rate. (2013)
  • Author(s): Fujimura T, Miura T, Nao T, Yoshimura M, Nakashima Y, Okada M, Okamura T, Yamada J, Ohshita C, Wada Y, Matsunaga N, Matsuzaki M, Yano M.
  • Journal Title: Heart Vessels Volume: 29 Issue: 4 Pages: 443-8
  • DOI: 10.1007/s00380-013-0383-5
  • Peer Reviewed
• [Journal Article] Volumetric evaluation of dual-energy perfusion CT for the assessment of intrapulmonary clot burden (2013)
  • Author(s): Munemasa Okada
  • Journal Title: Clin Radiol Volume: 68 Issue: 12 Pages: 669-75
  • DOI: 10.1016/j.crad.2013.07.018
  • Peer Reviewed
• [Journal Article] Volumetric evaluation of dual-energy perfusion CT by the presence of intrapulmonary clots using a 64-slice dual-source CT (2013)
  • Author(s): Okada M, Nakashima Y, Kunihiro Y, Nakao S, Morikage N, Sano Y, Suga K, Matsunaga N
  • Journal Title: Acta Radiol Volume: 54 Issue: 6 Pages: 628-633
  • DOI: 10.1177/0284185113479053
  • Peer Reviewed
• [Journal Article] Atherosclerosis: progress in diagnosis and treatments. Topics: III. Progress in diagnosis of atherosclerosis; 3. CT and MR imaging of atherosclerosis (2013)
  • Author(s): Okada M, Matsunaga N.
  • Journal Title: Nihon Naika Gakkai Zasshi Volume: 102 Pages: 325-34
• [Journal Article] 4. Dual-energy perfusion CT of non-diseased lung segments using dual-source CT: correlation with perfusion SPECT. (2013)
  • Author(s): Yoshie Kunihiro, Munemasa Okada, Naofumi Matsunaga, et al.
  • Journal Title: Jap J Radiol Volume: 31 Pages: 99-104
  • Peer Reviewed
• [Journal Article] 診断の進歩 CT(三次元再構成画像)、MRI (2013)
  • Author(s): 岡田宗正、松永尚文
  • Journal Title: 日本内科学雑誌 Volume: １０２ Pages: 325-334
• [Journal Article] The low attenuation area on dual-energy perfusion CT: correlation with the pulmonary function tests and quantitative CT measurements. (2012)
  • Author(s): Munemasa Okada, Yoshie Kunihiro, Yoshiteru Nakashima, et al.
  • Journal Title: Eur J Radiol Volume: 81 Pages: 2892-2899
  • Peer Reviewed
• [Journal Article] 心大血管・末梢血管外傷の画像診断 (2012)
  • Author(s): 岡田宗正、松永尚文ほか
  • Journal Title: 臨床画像 Volume: 28 Pages: 154-162
• [Presentation] Histogram analysis of dual-energy perfusion CT for acute pulmonary embolism. (2014)
  • Author(s): Okada M, Nomura T, Nakashima Y, Yonezawa T, Matsunaga N
  • Organizer: RSNA（北米放射線学会）
  • Place of Presentation: シカゴ（アメリカ）
  • Year and Date: 2014-11-30 – 2014-12-05
• [Presentation] Added Value Of Dual-energy Perfusion CT For Detection Of Acute Pulmonary Embolism. (2014)
  • Author(s): Okada M, Kunihiro Y, Nakashima Y, Nomura T, Kudomi S, Yonezawa T, Suga K, Matsunaga N.
  • Organizer: SCCT(心臓CT学会)
  • Place of Presentation: サンディエゴ（アメリカ）
  • Year and Date: 2014-07-10 – 2014-07-13
• [Presentation] Characteristic changes of three-and two-dimensional values of the left atrium using ECG-gated CT following ablation therapy: Assessment of left ventricular function, ECG results and BNP. (2014)
  • Author(s): Okada M, Matsunaga N
  • Organizer: SCCT（心臓ＣＴ学会）
  • Place of Presentation: サンディエゴ（アメリカ）
  • Year and Date: 2014-07-10 – 2014-07-13
• [Presentation] The difference of coronary vasodilation due to the plaque characteristics before and after the use of sublingual nitroglycerin on 64-slice coronary CT angiography. (2014)
  • Author(s): Okada M, Nakashima Y, Miura T, Nao T, Yoshimaura M, Sano Y, Matsunag N.
  • Organizer: 日本医学放射線学会総会
  • Place of Presentation: パシフィコ横浜（横浜市）
  • Year and Date: 2014-04-10 – 2014-04-13
• [Presentation] The difference of coronary vasodilation due to the plaque characteristics by the use of sublingual nitroglycerin on a 64-slice coronary CT angiography. (2013)
  • Author(s): Munemasa Okada, Yoshiteru Nakashima, Naofumi Matsunaga.
  • Organizer: SCCT 2013
  • Place of Presentation: モントリオール、カナダ
• [Presentation] The difference of coronary vasodilation due to the plaque characteristics by the use of sublingual nitroglycerin on 64-slice coronary CT angiography. (2013)
  • Author(s): Munemasa Okada, Yoshiteru Nakashima, Toshiro Miura, Tomoko Nao, Masayuki Yoshimura, Yuichi Sano, Naofumi Matsunaga.
  • Organizer: RSNA 2013
  • Place of Presentation: シカゴ、米国
• [Presentation] The difference of coronary vasodilation due to the plaque characteristics by the use of sublingual nitroglycerin on a 64-slice coronary CT angiography. (2013)
  • Author(s): Munemasa Okada, Yoshiteru Nakashima, Naofumi Matsunaga et al.
  • Organizer: Society of Cardiovascular Computed Tomography
  • Place of Presentation: モントリオール(Canada)
• [Presentation] Coronary vasodilation by the use of sublingual nitroglycerin on coronary dual source CT angiography. (2012)
  • Author(s): Munemasa Okada, Yoshiteru Nakashima, Naofumi Matsunaga
  • Organizer: Eurpean Society of Cardiac Radiology
  • Place of Presentation: Barcelona(Spain)