title: Sublingual Nitroglycerin Administration in Coronary Computed Tomography Angiography: a Systematic Review.
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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. rtakx@umcutrecht.nl.|Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3584 CX, Utrecht, The Netherlands. rtakx@umcutrecht.nl.
authors.forename: Richard A P
authors.initials: RA
authors.lastname: Takx
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3584 CX, Utrecht, The Netherlands.
authors.forename: Dominika
authors.initials: D
authors.lastname: Suchá
authors.affiliation: Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.|Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3584 CX, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.affiliation: Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
mesh_terms: D000286:Administration, Sublingual; D001794:Blood Pressure / Q000187:drug effects; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage / Q000494:pharmacology*; D014057:Tomography, X-Ray Computed
chemical_list: D005996:Nitroglycerin
keywords: Computed tomography; Coronary CT angiography; Coronary artery disease; Coronary vasodilation; Nitroglycerin