Anatomik alteration of coronary sinus in left ventricular systolic disfunction and relationship with NYHA functional status

Heart Failure is a major public health problem worldwide with high mortality and morbidity rates. Coronary sinus is a tubular structure which can be imaged echocardiographically as a sonolucency in the posterior atrioventricular groove. In our hypothesis, echocardiographic assesment of coronary sinus anatomic alteration, which has been ignored, may be part of remodelling process in heart failure. We aimed to evaluate the usefulness of examining the coronary sinus anatomic alteration as an additional surrogate marker in left ventricular systolic dysfunction.We prospectively studied 112 consecutive patients with heart failure and evidence of systolic dysfunction on echocardiographic examination on admission (EF < 40%). Age and gender matched 61 healthy subjects with normal echocardiography were enrolled to the study as control group. Statisticallly strong positive correlation were present between coronary sinus measurements and left/right ventricular volum (R=0.5, p<0.001; R=0.4, p<001, respectively), left atrial area (R=0.6, p<0.001), and NYHA class (R=0.3, p<001). Statistically negative correlation were present between coronary sinus measurements and left ventricle ejection fraction (R=-0.4, p<0.001).We clearly demonstrated that, in routine practice, there is an additional important role of the echocardiographic examination of coronary sinus anatomic alteration as assesment of the severity of systolic dysfunction and functional class status.Key Words: Coronary sinus, Heart failure, Echocardiography.