Non-invasive evaluation of the coronary venous system in patients with chronic systolic heart failure by 64-detector computed tomography
Küçük Resim Yok
Tarih
2011
Yazarlar
Cubuk, Rahmi
Aydin, Alper
Tasali, Nuni
Yilmazer, Serdar
Celik, Levent
Dagdeviren, Bahadir
Guney, Sefik
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
ROYAL SOC MEDICINE PRESS LTD
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background: Imaging coronary venous systems to guide transcatheter cardiac interventions are becoming increasingly important, particularly in heart failure patients who are selected for cardiac resynchronization therapy (CRT). Failure of left ventricular (LV) lead placement during the procedure has been attributed to the inability to insert catheters into the coronary sinus and the lack of suitable side branches. Purpose: To comparatively assess the value of a 64-detector MDCT examination in visualizing the cardiac veins and evaluating the morphological characteristics of the coronary venous system in patients with and without chronic systolic heart failure (SHF). Material and Methods: A 64-detector MDCT examination of the heart was performed in 26 consecutive patients (five women, 21 men; mean age 57.80 +/- 12.05 years; range 27-81 years) with chronic SHF. The morphological characteristics of the coronary venous system, such as the diameter, the distances between the venous tributaries, the angle and the tortuosity, were evaluated. The group was compared with a subgroup of 52 subjects without SHF (LV ejection fraction >40%) matched for age, sex, and the risk factors for coronary artery disease. Results: The coronary sinus (CS), great cardiac vein (GCV), anterior interventricular vein (AIV), and posterior interventricular vein (PIV) were visualized in all 78 individuals. The posterior vein of the left ventricle (PVLV) (63/78), left marginal vein (LMV) (72/78), and the small cardiac vein (SCV) (50/78) were visualized in SHF and control patients (p = NS). The lengths between venous tributaries were higher (p > 0.05) and more dilated (P < 0.001 for CS, GCV, AIV, PVLV, LMV; p = 0.001 for PIV) in the cases with SHF compared with the control population. The angle between the CS-GCV axis and the venous branches was wider (p = 0.02 for LMV and Ply, p = 0.001 for PVLV) and did not have any correlation with the LV diameter in cases with SHF. There was no difference between the SHF and control groups in terms of the tortuosity of PVLV and LMV (p = NS). Conclusion: The study demonstrated an increase in the diameters, lengths, and angulations with the CS-GCV axis of the coronary veins in cases with SHF. A 64-detector MDCT is a feasible tool for non-invasive evaluation of the coronary venous system and may provide considerable information regarding numbers and morphology of coronary veins before percutaneous transcatheter cardiac therapy.
Açıklama
Anahtar Kelimeler
Coronary venous system, multidetector computed tomography, ejection fraction, left ventricular diameter, coronary sinus
Kaynak
ACTA RADIOLOGICA
WoS Q Değeri
Q3
Scopus Q Değeri
Q3
Cilt
52
Sayı
4
