CCTA Evaluation Of The Coronary Vein And Its Adjacent Structures In Dilated Cardiomyopathy Patients And Mitral Valve Disease With Persistent Atrial Fibrillation Patients

[Objectives]To evaluate the morphological characteristics and rules of the coronary vein in dilated cardiomyopathy patients,and to assess the anatomical relationship between the coronary sinus-great cardiac vein(CS-GCV),mitral annulus(MA)and left circumferential artery(LCX)by using cardiac CT angiography(CCTA).[Materials and Methods]67 patients confirmed with dilated cardiomyopathy by echocardiography from November 1st 2017 to April 30ty 2023 in our hospital were subsumed in DC group who underwent CCTA scanning as well.In addition,67 subjects matched by gender,age,coronary risk factors,body mass index(BMI)and body surface area(BSA)with DC group were subsumed in Control group who were diagnosed with normal cardiac structure and function by echocardiography and CCTA.All clinical data and CCTA imaging data of the two groups were collected.CCTA image reconstruction was performed on Syngo.via workstation.Measurements performed on VR,MPR.Measurement parameters include:the diameter of the coronary sinus(CS)and main veins’ ostiums,the number and display rate of the posterior vein of left ventricle(PVLV)and the left marginal vein(LMV),and their distance to the CS Ostium(CSO),CS-GCV’s length(CS-GCV L),the farthest vertical distance between CS-GCV to MA(CS-GCV/MA D),the distance from CS-GCV’s the farthest MA vertical point to the CSO(MA:CS-GCV/CSO D),the sign of embedment of LCX,the distance from CS-GCV’s LCXE point to CSO(LCXE/CSO D),the volume of left atrium,left ventricle,right atrium and right ventricle.[Results]CS-GCV L,the distance LMV to CSO(LMV/CSO D),MA:CS-GCV/CSO D,and LCXE/CSO D were all increased in the DC group compared to the Control group(P<0.05).While the diameter of the coronary sinus(CS)and main veins’ ostiums,the display rate and number of PVLV and LMV,the distance of PVLV to CSO,CS-GCV/MA D,and the LCXE rate were not statistically different than those of the Control group(P>0.05).In DC group,CS-GCV L was positively correlated with pulmonary artery systolic pressure,the volume of left atrium,left ventricle,right atrium and right ventricle(P<0.05).Left atrial volume was an independent impact factor of CS-GCV length.In the DC group,there was no statistical difference in CS-GCV/MA D,MA:CS-GCV/CSO FD,LCXE/CSO D,and LCXE rate between the mild or no mitral regurgitation patients and the moderate to severe mitral regurgitation patients(P>0.05).[Conclusion]CCTA can accurately evaluate the anatomical characteristics of the coronary venous system and the relationship between CS-GCV,MA and LCX in DC patients,which can provide suggestions for screening the ideal surgery population and formulating the catheter or electrode implantation strategy.Dilated cardiomyopathy has some impacts on the anatomical parameters related to the coronary veins and its adjacent structures,DC patients’ CS-GCV is prolonged and mainly associated with left atrial dilatation。[Objectives]To evaluate the morphological characteristics of the coronary sinus(CS),the mitral isthmus-coronary vein(MI-CV)and its adjacent structures in patients with mitral valve disease and persistent atrial fibrillation(MVD&PAF),and to explore their changing rules by using cardiac CT angiography(CCTA).[Materials and Methods]33 patients confirmed with MVD&PAF by echocardiography and electrocardiogram from November 1st 2017 to April 30ty 2023 in our hospital were subsumed in MVD&PAF group who underwent CCTA scanning as well.In addition,two groups with matched gender,age and coronary risk factors comparing to MVD&PAF group were also subsumed,one was PAF group in which 33 PAF patients with no or mild MVD were included,and the other was Control group in which 66 patients with sinus rhythm and with no or mild MVD were included.All clinical data and CCTA imaging data of the three groups were collected.CCTA image reconstruction was performed on Syngo.via workstation.MPR were used for measurement.Measurement parameters include:CS diameter,MI-CV diameter,MI-CV to left atrial(LA)distance(MI-CV/LA D);the sign of insertion of left circumflex branch in mitral isthmus(LCXI);the volume of left atrium,left ventricle,right atrium and right ventricle.[Results]CS diameter was greater in MVD&PAF group compared to PAF and Control group(P<0.05).MI-CV diameter was greater in MVD&PAF group compared to the control group(P<0.05).There were no significant differences in LCXI rate and MI-CV/LA D among the three groups(P>0.05).In MVD&PAF group,MI-CV diameter was correlated with the volume of right atrial(P<0.05).CS diameter was correlated with the volume of right atrium and right ventricle(P<0.05).Right atrial volume was an independent impact factor of CS diameter.[Conclusion]CCTA can accurately evaluate the anatomical characteristics of the coronary vein and its adjacent structures,which can provide useful information for mitral isthmus ablation.MI-CV in MVD&PAF patients is broad and related to the enlargement of right atrium。...