Mlynarska Agnieszka, Mlynarski Rafal, Sosnowski Maciej
Department of Electrocardiology, Upper-Silesian Medical Center, Katowice, Poland.
Pacing Clin Electrophysiol. 2012 Dec;35(12):1472-9. doi: 10.1111/pace.12000. Epub 2012 Oct 4.
Whether the functional status of the heart can influence the coronary venous system itself has not yet been examined. In order to answer this question, we used multislice computed tomography (CT) imaging.
To answer the question of whether the heart failure (HF) is associated with significant anatomical changes in the coronary venous system?
In 136 (aged 56.6 ± 11.5) patients, a 64-slice CT was performed. Patients were divided into three groups according their ejection fraction. In each case, nine 3D volume rendering reconstructions, using a 2-mm layer with electrocardiographic-gating, were created at 0% to 90% R-R intervals (step 10%). The visualization of coronary veins (CVs) was graded independently by two experts trained in multislice computed tomography on a 0-5 point scale (0-not visible/lack of vein; 5-smoothly bordered vascular structure).
The average number of visible CVs per case was 3.44 in the HF group and 2.72 in patients with a normal ejection fraction (P = 0.0246). The statistical correlation between a reduction in ejection fraction and the increase in the number of veins was found (r =-0.2446, P < 0.05). For two of seven common variants of the coronary venous system at least two target veins (posterolateral and lateral) for cardiac resynchronization were presented.
The statistically higher number of veins in patients with heart failure may suggest an association between a failing heart and cardiac venous retention.
