Skip to main content
SpringerLink
Log in

Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate the feasibility of MRI for non-invasive assessment of the coronary sinus (CS) and the number and course of its major tributaries in heart failure patients.

Methods

Fourteen non-ischaemic heart failure patients scheduled for cardiac resynchronisation therapy (CRT) underwent additional whole-heart coronary venography. MRI was performed 1 day before device implantation. The visibility, location and dimensions of the CS and its major tributaries were assessed and the number of potential implantation sites identified. The MRI results were validated by X-ray venography conventionally acquired during the device implantation procedure.

Results

The right atrium (RA), CS and mid-cardiac vein (MCV) could be visualised in all patients. 36% of the identified candidate branches were located posterolaterally, 48% laterally and 16% anterolaterally. The average diameter of the CS was quantified as 9.8 mm, the posterior interventricular vein (PIV) 4.6 mm, posterolateral segments 3.3 mm, lateral 2.9 mm and anterolateral 2.9 mm. Concordance with X-ray in terms of number and location of candidate branches was given in most cases.

Conclusion

Contrast-enhanced MRI venography appears feasible for non-invasive pre-interventional assessment of the course of the CS and its major tributaries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Auricchio A, Stellbrink C, Sack S et al (2002) Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay. J Am Coll Cardiol 39:2026–2033

    Article  PubMed  Google Scholar 

  2. Cazeau S, Leclercq C, Lavergne T et al (2001) Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 344:873–880

    Article  PubMed  CAS  Google Scholar 

  3. Abraham WT, Fisher WG, Smith AL et al (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845–1853

    Article  PubMed  Google Scholar 

  4. Young JB, Abraham WT, Smith AL et al (2003) Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA 289:2685–2694

    Article  PubMed  Google Scholar 

  5. Bristow MR, Saxon LA, Boehmer J et al (2004) Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350:2140–2150

    Article  PubMed  CAS  Google Scholar 

  6. Cleland JGF, Daubert J, Erdmann E et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549

    Article  PubMed  CAS  Google Scholar 

  7. Ypenburg C, Westenberg JJ, Bleeker GB et al (2008) Noninvasive imaging in cardiac resynchronization therapy—part 1: selection of patients. Pacing Clin Electrophysiol 31:1475–1499

    Article  PubMed  Google Scholar 

  8. Ypenburg C, Van De Veire N, Westenberg JJ et al (2008) Noninvasive imaging in cardiac resynchronization therapy—Part 2: follow-up and optimization of settings. Pacing Clin Electrophysiol 31:1628–1639

    Article  PubMed  Google Scholar 

  9. Sá MI, de Roos A, Westenberg JJM, Kroft LJM (2008) Imaging techniques in cardiac resynchronization therapy. Int J Cardiovasc Imaging 24:89–105

    Article  PubMed  Google Scholar 

  10. Chung ES, Leon AR, Tavazzi L et al (2008) Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation 117:2608–2616

    Article  PubMed  Google Scholar 

  11. Busch S, Johnson TRC, Wintersperger BJ et al (2008) Quantitative assessment of left ventricular function with dual-source CT in comparison to cardiac magnetic resonance imaging: initial findings. Eur Radiol 18:570–575

    Article  PubMed  CAS  Google Scholar 

  12. Delfino JG, Fornwalt BK, Oshinski JN, Lerakis S (2008) Role of MRI in patient selection for CRT. Echocardiography 25:1176–1185

    Article  PubMed  Google Scholar 

  13. Rüssel IK, Zwanenburg JJM, Germans T et al (2007) Mechanical dyssynchrony or myocardial shortening as MRI predictor of response to biventricular pacing? J Magn Reson Imaging 26:1452–1460

    Article  PubMed  Google Scholar 

  14. Bilchick KC, Dimaano V, Wu KC et al (2008) Cardiac magnetic resonance assessment of dyssynchrony and myocardial scar predicts function class improvement following cardiac resynchronization therapy. JACC Cardiovasc Imaging 1:561–568

    Article  PubMed  Google Scholar 

  15. Henneman MM, van der Wall EE, Ypenburg C et al (2007) Nuclear imaging in cardiac resynchronization therapy. J Nucl Med 48:2001–2010

    Article  PubMed  Google Scholar 

  16. White JA, Yee R, Yuan X et al (2006) Delayed enhancement magnetic resonance imaging predicts response to cardiac resynchronization therapy in patients with intraventricular dyssynchrony. J Am Coll Cardiol 48:1953–1960

    Article  PubMed  Google Scholar 

  17. Helm RH, Lardo AC (2008) Cardiac magnetic resonance assessment of mechanical dyssynchrony. Curr Opin Cardiol 23:440–446

    Article  PubMed  Google Scholar 

  18. Delfino JG, Johnson KR, Eisner RL et al (2008) Three-directional myocardial phase-contrast tissue velocity MR imaging with navigator-echo gating: in vivo and in vitro study. Radiology 246:917–925

    Article  PubMed  Google Scholar 

  19. Götte MJW, Germans T, Rüssel IK et al (2006) Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function. J Am Coll Cardiol 48:2002–2011

    Article  PubMed  Google Scholar 

  20. Westenberg JJM, Lamb HJ, van der Geest RJ et al (2006) Assessment of left ventricular dyssynchrony in patients with conduction delay and idiopathic dilated cardiomyopathy: head-to-head comparison between tissue doppler imaging and velocity-encoded magnetic resonance imaging. J Am Coll Cardiol 47:2042–2048

    Article  PubMed  Google Scholar 

  21. Axel L, Montillo A, Kim D (2005) Tagged magnetic resonance imaging of the heart: a survey. Med Image Anal 9:376–393

    Article  PubMed  Google Scholar 

  22. Föll D, Jung B, Staehle F et al (2009) Visualization of multidirectional regional left ventricular dynamics by high-temporal-resolution tissue phase mapping. J Magn Reson Imaging 29:1043–1052

    Article  PubMed  Google Scholar 

  23. Rasche V, Binner L, Cavagna F et al (2007) Whole-heart coronary vein imaging: a comparison between non-contrast-agent- and contrast-agent-enhanced visualization of the coronary venous system. Magn Reson Med 57:1019–1026

    Article  PubMed  Google Scholar 

  24. Nezafat R, Han Y, Peters DC et al (2007) Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing. Magn Reson Med 58:1196–1206

    Article  PubMed  Google Scholar 

  25. Chiribiri A, Kelle S, Köhler U et al (2008) Magnetic resonance cardiac vein imaging: relation to mitral valve annulus and left circumflex coronary artery. JACC Cardiovasc Imaging 1:729–738

    Article  PubMed  Google Scholar 

  26. Stoeck CT, Han Y, Peters DC et al (2009) Whole heart magnetization-prepared steady-state free precession coronary vein MRI. J Magn Reson Imaging 29:1293–1299

    Article  PubMed  Google Scholar 

  27. Younger JF, Plein S, Crean A, Ball SG, Greenwood JP (2009) Visualization of coronary venous anatomy by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 11:26

    Article  PubMed  Google Scholar 

  28. Look DC, Locker DR (1970) Time saving in measurement of NMR and EPR relaxation times. Rev Sci Instrum 41:250–251

    Article  CAS  Google Scholar 

  29. Chiribiri A, Kelle S, Götze S et al (2008) Visualization of the cardiac venous system using cardiac magnetic resonance. Am J Cardiol 101:407–412

    Article  PubMed  Google Scholar 

  30. Dewey M, Kaufels N, Laule M et al (2004) Magnetic resonance imaging of myocardial perfusion and viability using a blood pool contrast agent. Invest Radiol 39:498

    Article  PubMed  Google Scholar 

  31. Maisel WH, Stevenson LW (2003) Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. JACC 91(Suppl 1):2–8

    Google Scholar 

Download references

Acknowledgements

RM is a full-time employee of Philips Research, Europe. VR receives grant support by Philips Healthcare.

Authors would like to thank Mrs. M. Duda and Mrs. A. Subgang for patient preparation and carrying out MRI.

Author information

Authors and Affiliations

  1. Department of Internal Medicine II, University Hospital of Ulm, Ulm, Germany

    Robert Manzke, Ludwig Binner, Axel Bornstedt, Nico Merkle, Anja Lutz, Robert Gradinger & Volker Rasche

  2. Philips Research Europe, Clinical Sites Research, Hamburg, Germany

    Robert Manzke

  3. Experimental Cardiovascular Imaging, Internal Medicine II, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    Volker Rasche

Authors
  1. Robert Manzke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ludwig Binner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Axel Bornstedt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nico Merkle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anja Lutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert Gradinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Volker Rasche
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Volker Rasche.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manzke, R., Binner, L., Bornstedt, A. et al. Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI. Eur Radiol 21, 799–806 (2011). https://doi.org/10.1007/s00330-010-1961-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1961-x

Keywords

Search

Navigation