Non-invasive visualization of the cardiac venous system in coronary artery disease patients using 64-slice computed tomography
Non-invasive visualization of the cardiac venous system in coronary artery disease patients using 64-slice computed tomography
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DOI：
10.1016/j.jacc.2006.07.042
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发表时间：
2006-11-07
影响因子：
24
通讯作者：
Bax, Jeroen J.
中科院分区：
文献类型：
--
作者：
Van de Veire, Nico R.;Schuijf, Joanne D.;Bax, Jeroen J.
目的 本研究旨在评估 64 层计算机断层扫描 (CT) 可视化心脏静脉的价值，并评估静脉解剖结构变化与梗塞病史之间的关系。 背景 心脏再同步治疗 (CRT) 对于某些心力衰竭患者来说是一种有吸引力的治疗方法。静脉解剖学知识可能有助于确定成功左心室导线植入的候选者。方法对 100 名个体（年龄 61 +/- 11 岁，68% 男性）的 64 层 CT 进行研究。受试者被分为 3 组：28 名对照患者、38 名患有严重冠状动脉疾病 (CAD) 的患者和 34 名有梗塞病史的患者。评估以下冠状窦 (CS) 支流的存在：后室间静脉 (PIV)、左心室后静脉和左边缘静脉 (LMV)。还测量了血管直径。 结果 所有个体的冠状窦和 PIV 均被识别。 96% 的对照患者、84% 的 CAD 患者和 82% 的梗塞患者观察到左心室后静脉。在有梗塞病史的患者中，与对照患者和 CAD 患者相比，观察到的 LMV 显着减少（分别为 27% vs. 71% 和 61%，p < 0.001）。没有一名侧部梗塞患者有 LMV，只有 22% 的前部梗塞患者有 LMV。关于定量数据，各组之间没有观察到显着差异。结论用64层CT对心脏静脉进行无创评估是可行的。静脉解剖结构存在很大差异。有梗塞病史的患者出现 LMV 的可能性较小，这可能会妨碍 CRT 植入中左心室导线的最佳定位。
OBJECTIVES This study was designed to evaluate the value of 64-slice computed tomography (CT) to visualize the cardiac veins and evaluate the relation between variations in venous anatomy and history of infarction.BACKGROUND Cardiac resynchronization therapy (CRT) is an attractive treatment for selected heart failure patients. Knowledge of venous anatomy may help in identifying candidates for successful left ventricular lead implantation.METHODS The 64-slice CT of 100 individuals (age 61 +/- 11 years, 68% men) was studied. Subjects were divided into 3 groups: 28 control patients, 38 patients with significant coronary artery disease (CAD), and 34 patients with a history of infarction. Presence of the following coronary sinus (CS) tributaries was evaluated: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV). Vessel diameters were also measured.RESULTS Coronary sinus and PIV were identified in all individuals. Posterior vein of the left ventricle was observed in 96% of control patients, 84% of CAD patients, and 82% of infarction patients. In patients with a history of infarction, a LMV was significantly less observed as compared with control patients and CAD patients (27% vs. 71% and 61%, respectively, p < 0.001). None of the patients with lateral infarction and only 22% of patients with anterior infarction had a LMV. Regarding quantitative data, no significant diffierences were observed between the groups.CONCLUSIONS Non-invasive evaluation of cardiac veins with 64-slice CT is feasible. There is considerable variation in venous anatomy. Patients with a history of infarction were less likely to have a LMV, which may hamper optimal left ventricular lead positioning in CRT implantation.