Cetin Mustafa, Cakici Musa, Zencir Cemil, Tasolar Hakan, Cil Ercan, Yıldız Emrah, Balli Mehmet, Abus Sabri, Akturk Erdal
Adiyaman University, School of Medicine, Department of Cardiology, Adiyaman, Turkey.
Adiyaman University, School of Medicine, Department of Cardiology, Adiyaman, Turkey.
Rev Port Cardiol. 2015 May;34(5):329-35. doi: 10.1016/j.repc.2014.11.017. Epub 2015 May 7.
We investigated the relationship between coronary sinus (CS) diameter and pulmonary artery systolic pressure (PASP) in patients with pulmonary hypertension (PH) and normal left ventricular systolic function.
A total of 155 participants referred for transthoracic echocardiography were included in the study. The study population consisted of 100 patients with chronic PH and 55 control subjects. Patients with PH were divided into two groups according to PASP: those with PASP 36-45 mmHg, the mild PH group (n=53); and those with PASP >45 mmHg, the moderate to severe PH group (n=47). CS diameter was measured from the posterior atrioventricular groove in apical 4-chamber view during ventricular systole according to the formula: mean CS=(proximal CS+mid CS+distal CS)/3.
Mean CS diameter was significantly higher in the moderate to severe PH group than in the controls and in the mild PH group (1.12±0.2 cm vs. 0.82±0.1 cm and 0.87±0.1 cm, respectively; p<0.001). It was significantly correlated with right atrial (RA) area (r=0.674, p<0.001), RA pressure (r=0.458, p<0.001), PASP (r=0.562, p<0.001), inferior vena cava diameter (r=0.416, p<0.001), right ventricular E/A ratio (r=-0.290, p<0.001), and E/Em ratio (r=0.235, p=0.004). RA area (β=0.475, p<0.001) and PASP (β=0.360, p=0.002) were found to be independent predictors of CS diameter.
A dilated CS was associated with moderate to severe pulmonary hypertension, and RA area and PASP were independent predictors of CS diameter.
我们研究了肺动脉高压（PH）且左心室收缩功能正常的患者的冠状窦（CS）直径与肺动脉收缩压（PASP）之间的关系。
共有155名接受经胸超声心动图检查的参与者纳入本研究。研究人群包括100例慢性PH患者和55名对照者。根据PASP将PH患者分为两组：PASP为36 - 45 mmHg者，轻度PH组（n = 53）；PASP > 45 mmHg者，中度至重度PH组（n = 47）。在心室收缩期，于心底四腔心切面从房室后沟测量CS直径，计算公式为：平均CS =（近端CS + 中段CS + 远端CS）/ 3。
中度至重度PH组的平均CS直径显著高于对照组和轻度PH组（分别为1.12±0.2 cm vs. 0.82±0.1 cm和0.87±0.1 cm；p < 0.001）。它与右心房（RA）面积（r = 0.674，p < 0.001）、RA压力（r = 0.458，p < 0.001）、PASP（r = 0.562，p < 0.001）、下腔静脉直径（r = 0.416，p < 0.001）、右心室E/A比值（r = -0.290，p < 0.001）以及E/Em比值（r = 0.235，p = 0.004）显著相关。发现RA面积（β = 0.475，p < 0.001）和PASP（β = 0.360，p = 0.002）是CS直径的独立预测因素。
CS扩张与中度至重度肺动脉高压相关，且RA面积和PASP是CS直径的独立预测因素。
