TY - JOUR
T1 - Pulmonary vein contraction
T2 - Characterization of dynamic changes in pulmonary vein morphology using multiphase multislice computed tomography scanning
AU - Thiagalingam, Aravinda
AU - Reddy, Vivek Y.
AU - Cury, Ricardo C.
AU - Abbara, Suhny
AU - Holmvang, Godtfred
AU - Thangaroopan, Molly
AU - Ruskin, Jeremy N.
AU - d'Avila, Andre
N1 - Funding Information:
National Heart Foundation/National Health and Medical Research Council (NHF/NHMRC) A.T. is supported by a NHF/NHMRC Neil Hamilton Fairley Fellowship, grant no. 408106.
PY - 2008/12
Y1 - 2008/12
N2 - Background: The presence and extent of contraction within the pulmonary veins (PVs) have not been defined clearly. Objective: The purpose of this study was to determine whether PV contraction exists and can be visualized using multislice computed tomography (MSCT) scanning as this may indicate that this modality may be useful for monitoring patients after PV isolation procedures. Methods: Analysis was performed on 29 patients (mean age 57.5 ± 12 years) undergoing MSCT for suspected coronary artery disease without structural heart disease or left atrial anatomical variants. Multiplane reconstructions were used to measure PV diameters at 0, 5, 10, and 15 mm from the ostium in two phases (maximum and minimum size). The ejection fractions of three 5-mm segments were calculated for each PV. Results: Right-sided and left-sided PV contraction and maximal atrial contraction occurred at a median of 85% and 95% of the cardiac cycle, respectively. The temporal concordance of minimal PV volume during peak atrial contraction indicated that the PV volume changes are secondary to active contraction rather than passive reflux and PV distension. The ejection fractions were highest in the superior veins: right superior PV (36.7%, 27.8%, and 16%, respectively, for the three segments from proximal to distal) and left superior PV (26.9%, 21.3%, and 12.1%), in comparison with the right inferior PV (21.1%, 6.6%, and -0.7%) and left inferior PV (15%, 9.3%, and 7.6%). Conclusion: Volume changes related to active PV contraction occur extending up to 15 mm into the veins, and this effect is most pronounced in the superior veins.
AB - Background: The presence and extent of contraction within the pulmonary veins (PVs) have not been defined clearly. Objective: The purpose of this study was to determine whether PV contraction exists and can be visualized using multislice computed tomography (MSCT) scanning as this may indicate that this modality may be useful for monitoring patients after PV isolation procedures. Methods: Analysis was performed on 29 patients (mean age 57.5 ± 12 years) undergoing MSCT for suspected coronary artery disease without structural heart disease or left atrial anatomical variants. Multiplane reconstructions were used to measure PV diameters at 0, 5, 10, and 15 mm from the ostium in two phases (maximum and minimum size). The ejection fractions of three 5-mm segments were calculated for each PV. Results: Right-sided and left-sided PV contraction and maximal atrial contraction occurred at a median of 85% and 95% of the cardiac cycle, respectively. The temporal concordance of minimal PV volume during peak atrial contraction indicated that the PV volume changes are secondary to active contraction rather than passive reflux and PV distension. The ejection fractions were highest in the superior veins: right superior PV (36.7%, 27.8%, and 16%, respectively, for the three segments from proximal to distal) and left superior PV (26.9%, 21.3%, and 12.1%), in comparison with the right inferior PV (21.1%, 6.6%, and -0.7%) and left inferior PV (15%, 9.3%, and 7.6%). Conclusion: Volume changes related to active PV contraction occur extending up to 15 mm into the veins, and this effect is most pronounced in the superior veins.
KW - Atrium
KW - CT scanning
KW - Imaging
KW - Myocardial contraction/physiology
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U2 - 10.1016/j.hrthm.2008.09.010
DO - 10.1016/j.hrthm.2008.09.010
M3 - Article
C2 - 19084798
AN - SCOPUS:59749090143
SN - 1547-5271
VL - 5
SP - 1645
EP - 1650
JO - Heart Rhythm
JF - Heart Rhythm
IS - 12
ER -