Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Assessment of blood flow in the coronary sinus by the method of MR 4D-flow

Authors: M.A. Shlyappo, E.Yu. Glazkova, S.A. Aleksandrova, L.A. Yurpol'skaya, V.N. Makarenko, L.A. Bockeria

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2019-16-1-30-35

UDC: 616.132.2:612.1]-073.756.8

Link: Clinical Physiology of Blood Circulaiton. 2019; 16 (1): 30-35

Quote as: Shlyappo M.A., Glazkova E.Yu., Aleksandrova S.A., Yurpol'skaya L.A., Makarenko V.N., Bockeria L.A. Assessment of blood flow in the coronary sinus by the method of MR 4D-flow. Clinical Physiology of Circulation. 2019; 16 (1): 30–5 (in Russ.). DOI: 10.24022/1814-6910-2019-16-1-30-35

Received / Accepted:  14.01.2019/17.01.2019

Full text:  

Abstract

Objective. To study hemodynamic changes in the coronary sinus in patients with valvular heart diseases (VHD) using the 4D-flow method.

Material and methods. The prospective analysis included 50 patients: 30 patients without cardiac pathology and 20 patients with VHD and pulmonary hypertension. The standard protocol of the MR study included spin echo, gradient echo: cine and phase-contrast sequences of the coronary sinus (CS) region. A program for three-dimensional scanning of the heart was also included (coronary MR-angiography) against the background of contrast enhancement for visualization of the coronary veins. To assess the blood flow, an MRI card was used to scan 4D-flow.

Results. The peak velocity in the CS in the group of patients without cardiac pathology was 31.54±13.17 cm/s, in patients with pathology it was significantly different and was 18.77±4.42 cm/s. The volume of inflow to the right atrium in the first group was 0.78 ml, in the second it was also significantly different and was equal to 1.04 ml. In the group of patients with VHD, a significant relationship was found between the diameter of the orifice of the coronary sinus and the volume of inflow into the right atrium (R=0.65, p=0.005). However, no relationship between the peak velocity in the CS and the mouth diameter was revealed (R=0.21, p=0.39). In a graphical analysis of changes in the rate of volumetric blood flow in the coronary sinus during the cardiac cycle, two antegrade waves of peak blood flow velocity were detected. Patients with VHD had similar waves, but with less pronounced peaks.

Conclusions. The 4D-flow program allows non-invasive in-line quantitative and qualitative assessment of blood flow in the CS in patients with VHD and pulmonary hypertension, which expands the possibilities of in-depth study of hemodynamics at VHD.

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About Authors

  • Mariya A. Shlyappo, Cand. Med. Sc., Radiologist; orcid.org/0000-0001-6264-8919
  • Elena Yu. Glazkova, Cand. Med. Sc., Researcher; orcid.org/0000-0003-3310-3658
  • Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher; orcid.org/0000-0002-7795-9709
  • Lyudmila A. Yurpol'skaya, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0001-7780-2405
  • Vladimir N. Makarenko, Dr. Med. Sc., Professor, Head of X-ray Department; orcid.org/0000-0002-8700-7592
  • Leo A. Bockeria, Dr. Med. Sc., Professor, Academician of RAS and RAMS, Director; orcid.org/0000-0002-6180-2619

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