{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:06:31Z","timestamp":1763535991596,"version":"3.37.3"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002468","name":"Dong-A University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002468","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>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).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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 (\u2018baseline CT\u2019) and CCTA during continuous intravenous nitrate infusion (\u2018IV nitrate CT\u2019). 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0271189","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T18:05:39Z","timestamp":1657303539000},"page":"e0271189","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessment of coronary spasms with transluminal attenuation gradient in coronary computed tomography angiography"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-2380","authenticated-orcid":true,"given":"Jae Yang","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0937-3607","authenticated-orcid":true,"given":"Eun-Ju","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moo Hyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwan Seok","family":"Yong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Woon","family":"Rha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"key":"pone.0271189.ref001","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1067\/mhj.2002.123843","article-title":"Coronary vasospasm as a possible cause of elevated cardiac troponin I in patients with acute coronary syndrome and insignificant coronary artery disease","volume":"144","author":"C-H Wang","year":"2002","journal-title":"Am Heart J"},{"key":"pone.0271189.ref002","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jacc.2008.04.050","article-title":"Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study.","volume":"52","author":"P Ong","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"pone.0271189.ref003","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jjcc.2012.12.008","article-title":"Clinical impact of coronary artery spasm in patients with no significant coronary stenosis who are experiencing acute coronary syndrome","volume":"61","author":"S Satoh","year":"2013","journal-title":"J Cardiol"},{"key":"pone.0271189.ref004","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.acvd.2011.01.012","article-title":"Sudden death caused by atypical variant angina.","volume":"104","author":"F Laporte","year":"2011","journal-title":"Arch Cardiovasc Dis"},{"key":"pone.0271189.ref005","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jjcc.2008.01.001","article-title":"Coronary artery spasm\u2014clinical features, diagnosis, pathogenesis, and treatment.","volume":"51","author":"H Yasue","year":"2008","journal-title":"J 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