Conflict of interest: No conflicts of interest for all.
Coronary Venous Retention—A Feature in Heart Failure as Evidenced by Mean of Cardiac Computed Tomography
Article first published online: 4 OCT 2012
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 12, pages 1472–1479, December 2012
How to Cite
MLYNARSKA, A., MLYNARSKI, R. and SOSNOWSKI, M. (2012), Coronary Venous Retention—A Feature in Heart Failure as Evidenced by Mean of Cardiac Computed Tomography. Pacing and Clinical Electrophysiology, 35: 1472–1479. doi: 10.1111/pace.12000
- Issue published online: 7 DEC 2012
- Article first published online: 4 OCT 2012
- Received April 29, 2012; revised July 4, 2012; accepted July 9, 2012.
- heart failure;
- coronary veins;
- cardiac resynchronization therapy;
- computed tomography
Background: 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.
Purpose: To answer the question of whether the heart failure (HF) is associated with significant anatomical changes in the coronary venous system?
Methods: 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).
Results: 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.
Conclusions: The statistically higher number of veins in patients with heart failure may suggest an association between a failing heart and cardiac venous retention. (PACE 2012;35:1472–1479)