Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography.
<h4>Purpose</h4>To evaluate the imaging features of coronary spasm, including transluminal attenuation gradient (TAG) on coronary computed tomography angiography (CCTA), in patients with vasospastic angina (VA).<h4>Methods</h4>A total of 43 patients with a high clinical likel...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0271189 |
| _version_ | 1818041124590190592 |
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| author | Jae Yang Park Eun-Ju Kang Moo Hyun Kim Hwan Seok Yong Seung-Woon Rha |
| author_facet | Jae Yang Park Eun-Ju Kang Moo Hyun Kim Hwan Seok Yong Seung-Woon Rha |
| author_sort | Jae Yang Park |
| collection | DOAJ |
| description | <h4>Purpose</h4>To evaluate the imaging features of coronary spasm, including transluminal attenuation gradient (TAG) on coronary computed tomography angiography (CCTA), in patients with vasospastic angina (VA).<h4>Methods</h4>A total of 43 patients with a high clinical likelihood of VA were included in the study. All the subjects underwent double CCTA acquisition: CCTA without a vasodilator ('baseline CT') and CCTA during continuous intravenous nitrate infusion ('IV nitrate CT'). A catheterized ergonovine provocation test was used to determine true VA patients. Coronary spasm is classified into focal- and diffuse-types according to morphological differences. We measured TAG and contrast enhancement of the proximal ostium (ProxHU) of each coronary artery for both the baseline and IV nitrate CT.<h4>Results</h4>Twenty-four patients (55.8%) showed positive results of coronary vasospasm on the provocation test. Thirty-eight vessels showed coronary spasms (29.5%): Focal-type in nine vessels (24%), and diffuse-type in 29 (76%). In the baseline CT, LCX showed significantly lower (steeper) TAG in spasm(+) vessels than in spasm(-) vessels, while LAD and RCA showed no significant differences in TAG. The ProxHU of LAD showed significantly lower values in spasm(+) vessels than in spasm(-) vessels, while the other vessels did not show significant differences in ProxHU. For IV nitrate CT, there were no significant differences in either the TAG and ProxHU between spasm(+) and (-) vessels for all the three vessel types. In subgroup analysis for spasm(+) vessels, diffuse spasms showed significantly lower TAG than focal spasms, while the ProxHU did not differ between the two types of spasm.<h4>Conclusions</h4>A relatively large percentage of coronary spasms present as diffuse type, and the TAG values significantly differed according to the morphological type of the coronary spasm. |
| first_indexed | 2024-12-10T08:25:26Z |
| format | Article |
| id | doaj.art-2855103bdcc74329812d4737bdf218a6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T08:25:26Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2855103bdcc74329812d4737bdf218a62022-12-22T01:56:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027118910.1371/journal.pone.0271189Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography.Jae Yang ParkEun-Ju KangMoo Hyun KimHwan Seok YongSeung-Woon Rha<h4>Purpose</h4>To evaluate the imaging features of coronary spasm, including transluminal attenuation gradient (TAG) on coronary computed tomography angiography (CCTA), in patients with vasospastic angina (VA).<h4>Methods</h4>A total of 43 patients with a high clinical likelihood of VA were included in the study. All the subjects underwent double CCTA acquisition: CCTA without a vasodilator ('baseline CT') and CCTA during continuous intravenous nitrate infusion ('IV nitrate CT'). A catheterized ergonovine provocation test was used to determine true VA patients. Coronary spasm is classified into focal- and diffuse-types according to morphological differences. We measured TAG and contrast enhancement of the proximal ostium (ProxHU) of each coronary artery for both the baseline and IV nitrate CT.<h4>Results</h4>Twenty-four patients (55.8%) showed positive results of coronary vasospasm on the provocation test. Thirty-eight vessels showed coronary spasms (29.5%): Focal-type in nine vessels (24%), and diffuse-type in 29 (76%). In the baseline CT, LCX showed significantly lower (steeper) TAG in spasm(+) vessels than in spasm(-) vessels, while LAD and RCA showed no significant differences in TAG. The ProxHU of LAD showed significantly lower values in spasm(+) vessels than in spasm(-) vessels, while the other vessels did not show significant differences in ProxHU. For IV nitrate CT, there were no significant differences in either the TAG and ProxHU between spasm(+) and (-) vessels for all the three vessel types. In subgroup analysis for spasm(+) vessels, diffuse spasms showed significantly lower TAG than focal spasms, while the ProxHU did not differ between the two types of spasm.<h4>Conclusions</h4>A relatively large percentage of coronary spasms present as diffuse type, and the TAG values significantly differed according to the morphological type of the coronary spasm.https://doi.org/10.1371/journal.pone.0271189 |
| spellingShingle | Jae Yang Park Eun-Ju Kang Moo Hyun Kim Hwan Seok Yong Seung-Woon Rha Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. PLoS ONE |
| title | Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. |
| title_full | Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. |
| title_fullStr | Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. |
| title_full_unstemmed | Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. |
| title_short | Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography. |
| title_sort | assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography |
| url | https://doi.org/10.1371/journal.pone.0271189 |
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