Key result
Whole-heart cardiovascular magnetic resonance angiography using a standard extracellular contrast agent successfully visualized the cardiac venous system in all patients and the lateral left ventricular vein in 74% of patients.
Why the study?
Can coronary venous anatomy be reliably depicted using a comprehensive CMR protocol with a standard extracellular contrast agent?
Observational (n=31)
Can coronary venous anatomy be reliably depicted using a comprehensive CMR protocol with a standard extracellular contrast agent?
Coronary venous anatomy can be reliably visualized using a standard 3D whole-heart CMR protocol with extracellular gadolinium contrast, which may aid in planning cardiac resynchronization therapy.
CMR may integrate venous mapping with function and viability assessment in HF patients considered for CRT; leaves open prospective outcome studies.
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. METHODS AND 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. CONCLUSION: 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.
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Younger et al. (2009) conducted an observational in Suspected coronary artery disease (n=31). 3D whole heart cardiovascular magnetic resonance (CMR) angiography was evaluated on Visualization of the lateral vein of the left ventricle. Whole-heart cardiovascular magnetic resonance angiography using a standard extracellular contrast agent successfully visualized the cardiac venous system in all patients and the lateral left ventricular vein in 74% of patients.