title: Cardiac Vein Accessibility According to Heart Diseases and Sex: Implications for Cardiac Resynchronization Therapy.
abstract: Cardiac resynchronization therapy (CRT) is an important therapy in patients with heart failure (HF) and dyssynchrony. We performed the present study to elucidate clinical factors associated with cardiac vein accessibility.
  
  
  
  In 255 consecutive patients (age, 48.7 ± 19.4 years; male, 126), cardiac venography was performed during CRT implantation or an electrophysiological study. We measured the diameters and the proximal branching angles of the lateral cardiac and posterior ventricular veins. Easy accessibility of the cardiac vein was defined as a lumen diameter ≥1.6 mm with an angle of ≥90°. We compared baseline characteristics between patients with and without easily accessible cardiac veins. We compared cardiac vein accessibility between patients with and without HF, including ischemic and nonischemic HF, and between males and females.
  
  
  
  In 189 (74.1%) patients, the cardiac veins were easily accessible. The cardiac veins were more easily accessible in patients with HF (n = 75) compared with patients without HF (n = 180; 89.3% and 67.8%, respectively; P < 0.001). The cardiac veins were more easily accessible in patients with nonischemic HF (n = 56) compared with patients with ischemic HF (n = 19; 96.4% and 68.4%, respectively; P = 0.003). The cardiac veins were more easily accessible in females compared with males (79.8% and 68.3%, respectively; P = 0.035).
  
  
  
  Accessing the cardiac veins for CRT implantation was difficult in ∼10% of patients with HF. Cardiac vein accessibility was high in patients with nonischemic HF and in females.
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Je Wook
authors.initials: JW
authors.lastname: Park
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hancheol
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong-Chan
authors.initials: JC
authors.lastname: Youn
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D003331:Coronary Vessels; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
keywords: accessibility; cardiac resynchronization therapy; cardiac vein; heart failure