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European Radiology

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Open Access 01-12-2015 | Cardiac

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

Authors: Richard A. P. Takx, Dominika Suchá, Jakob Park, Tim Leiner, Udo Hoffmann

Published in: European Radiology | Issue 12/2015

Abstract

Objective

To systematically investigate the literature for the influence of sublingual nitroglycerin administration on coronary diameter, the number of evaluable segments, image quality, heart rate and blood pressure, and diagnostic accuracy of coronary computed tomography (CT) angiography.

Methods

A systematic search was performed in PubMed, EMBASE and Web of Science. The studies were evaluated for the effect of sublingual nitroglycerin on coronary artery diameter, evaluable segments, objective and subjective image quality, systemic physiological effects and diagnostic accuracy. Due to the heterogeneous reporting of outcome measures, a narrative synthesis was applied.

Results

Of the 217 studies identified, nine met the inclusion criteria: seven reported on the effect of nitroglycerin on coronary artery diameter, six on evaluable segments, four on image quality, five on systemic physiological effects and two on diagnostic accuracy. Sublingual nitroglycerin administration resulted in an improved evaluation of more coronary segments, in particular, in smaller coronary branches, better image quality and improved diagnostic accuracy. Side effects were mild and were alleviated without medical intervention.

Conclusion

Sublingual nitroglycerin improves the coronary diameter, the number of assessable segments, image quality and diagnostic accuracy of coronary CT angiography without major side effects or systemic physiological changes.

Key Points

• Sublingual nitroglycerin administration results in significant coronary artery dilatation.

• Nitroglycerin increases the number of evaluable coronary branches.

• Image quality is improved the most in smaller coronary branches.

• Nitroglycerin increases the diagnostic accuracy of coronary CT angiography.

• Most side effects are mild and do not require medical intervention.

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Title: Sublingual Nitroglycerin Administration in Coronary Computed Tomography Angiography: a Systematic Review
Authors: Richard A. P. Takx
Dominika Suchá
Jakob Park
Tim Leiner
Udo Hoffmann
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3791-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objective

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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