Visualization of coronary venous anatomy by cardiovascular magnetic resonance.
BACKGROUND
Coronary venous imaging with whole-heart cardiovascular magnetic resonance (CMR) angiography has recently been described using developmental pulse sequences and intravascular contrast agents. However, the practical utility of coronary venous imaging will be for patients with heart failure in whom cardiac resynchronisation therapy (CRT) is being considered. As such complementary information on ventricular function and myocardial viability will be required. The aim of this study was to determine if the coronary venous anatomy could be depicted as part of a comprehensive CMR protocol and using a standard extracellular contrast agent.


RESULTS
Thirty-one 3D whole heart CMR studies, performed after intravenous administration of 0.05 mmol/kg gadolinium DTPA, were reviewed. The cardiac venous system was visualized in all patients. The lateral vein of the left ventricle was present in 74%, the anterior interventricular vein in 65%, and the posterior interventricular vein in 74% of patients. The mean maximum distance of demonstrable cardiac vein on the 3D images was 81.5 mm and was dependent on the quality of the 3D data set. Five patients showed evidence of myocardial infarction on late gadolinium enhancement (LGE) images.


CONCLUSIONS
Coronary venous anatomy can be reliably demonstrated using a comprehensive CMR protocol and a standard extracellular contrast agent. The combination of coronary venous imaging, assessment of ventricular function and LGE may be useful in the management of patients with LV dysfunction being considered for CRT.
Younger
John F
JF
Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK. John_Younger@health.qld.gov.au
Plein
Sven
S
Crean
Andrew
A
Ball
Stephen G
SG
Greenwood
John P
JP
D000368:Aged; D002932:Cineangiography; D003287:Contrast Media / Q000008:administration & dosage; D003331:Coronary Vessels / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D021621:Imaging, Three-Dimensional; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014680:Veins / Q000473:pathology; D016277:Ventricular Function, Left
D003287:Contrast Media; D019786:Gadolinium DTPA