title: Assessment of coronary artery disease with nicorandil stress magnetic resonance imaging.
abstract: BACKGROUND
  Although dipyridamole and adenosine have been used as vasodilator agents, we believe they are inadequate for vasodilator perfusion magnetic resonance imaging, due to adverse effects (flushing, warmth, headaches, and arrhythmia). Nicorandil, a potassium channel opener, has been reported to increase coronary blood flow and it was associated with fewer adverse effects than adenosine or dipiridamole. We set out to investigate whether the coronary artery stenosis could be assessed by nicorandil stress perfusion magnetic resonance imaging.
  
  
  METHODS
  First-pass contrast-enhanced magnetic resonance images of the left ventricle acquired from 50 patients at rest and during intravenous administration of nicorandil using multi-slice turbo field echo with multi shot echo-planar-imaging. Coronary angiography was performed within 1 week.
  
  
  RESULTS
  There was no adverse effects during nicorandil stress in any patients. The overall sensitivity and specificity of magnetic resonance imaging in identifying patients with significant stenosis of at least one coronary artery were 93.9% (31 of 33 patients) and 94.1% (16 of 17 patients), respectively. The sensitivity of magnetic resonance imaging for detecting significant stenosis in the left anterior descending artery was 87.5%; the sensitivity in the left circumflex artery was 80%; the sensitivity in the right coronary artery was 92.3%. Similar sensitivities were observed for all 3 vascular regions, indicating that all myocardial segments were visualized with similar image quality.
  
  
  CONCLUSIONS
  The present study shows that nicorandil stress perfusion magnetic resonance imaging is a safe, feasible technique for assessing coronary artery stenosis severity in a totally-noninvasive manner.
authors.affiliation: Department of Cardiology, Izumi City General Hospital, Osaka, Japan. y-kawase@js4.so-net.ne.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kawase
authors.forename: Masaki
authors.initials: M
authors.lastname: Nishimoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Hato
authors.forename: Kazue
authors.initials: K
authors.lastname: Okajima
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D017352:Echo-Planar Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020108:Nicorandil; D013997:Time Factors; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D020108:Nicorandil