https://scholars.lib.ntu.edu.tw/handle/123456789/511051
標題: | Morphologic and Topologic Characteristics of Coronary Venous System Delineated by Noninvasive Multidetector Computed Tomography in Chronic Systolic Heart Failure Patients | 作者: | JIEN-JIUN CHEN WEN-JENG LEE YI-CHIH WANG CHIA-TI TSAI LING-PING LAI HWANG, JUEY-JEN JIUNN-LEE LIN |
公開日期: | 2007 | 卷: | 13 | 期: | 6 | 起(迄)頁: | 482-488 | 來源出版物: | Journal of Cardiac Failure | 摘要: | Background: Variations of coronary venous system in a dilated, failing heart may well be unpredictable. Noninvasive preview of coronary veins before left ventricular (LV) lead implantation for cardiac resynchronization therapy would facilitate successful procedure in chronic systolic heart failure (SHF) patients. Methods and Results: Multidetector computed tomography (MDCT) of the heart was investigated in 23 consecutive patients of chronic SHF with LV ejection fraction ?40%. Morphologic and topologic characteristics of coronary venous system were studied, and compared with 23 age-matched controls. All coronary veins including coronary sinus, posterior interventricular vein (PIV), LV posterior vein, left margin vein (LMV), and anterior interventricular vein (AIV) were clearly visible in all 23 SHF patients and 23 normal controls. Total coronary venous length (ie, from PIV to AIV) was directly correlated with LV volume (r = 0.65, P < .001). The main lengthened venous segment was between LMV and AIV. Ostial diameters of all coronary venous tributaries were larger in SHF patients, but the angle of branching was similar. However, the secondary angle of the coronary sinus relative to superior vena cava axis was more acute (30 ± 7°) in SHF patients than that in normal (44 ± 8°, P < .001). Local aneurysm locating at LV posterolateral wall could detour relevant coronary vein tributaries to the outer border of the aneurysm, compress venous dimensions throughout the cardiac cycle, and cause acute angulation of venous tributaries. Conclusions: Coronary venous system shown by MDCT in SHF patients with low LV ejection fraction manifested longer venous length between LMV and AIV, acute secondary CS angle, and usually topologically distorted by posterolateral LV aneurysms. A panoramic delineation of all coronary venous tributaries could help effective venous intervention. ? 2007 Elsevier Inc. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/511051 | ISSN: | 1071-9164 | DOI: | 10.1016/j.cardfail.2007.02.007 | SDG/關鍵字: | adult; aged; article; clinical article; controlled study; coronary sinus; coronary vein; correlation analysis; female; heart cycle; heart failure; heart left ventricle aneurysm; heart left ventricle ejection fraction; heart left ventricle volume; human; male; multidetector computed tomography; priority journal; superior cava vein; Adult; Aged; Aged, 80 and over; Coronary Angiography; Coronary Circulation; Coronary Vessels; Female; Heart Failure, Congestive; Humans; Male; Middle Aged; Myocardial Contraction; Prognosis; Reproducibility of Results; Retrospective Studies; Severity of Illness Index; Stroke Volume; Systole; Tomography, X-Ray Computed; Ventricular Function, Left |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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