Coronary Sinus Dilatation and Right Ventricular Function in Cardiomyopathy Patients

Background: The coronary sinus is a venous tube-like structure about 2-3 cm long located one centimeter from the atrial side of the atrioventricular junction. It serves as the major venous drainage system of the heart, carrying venous blood from the cardiac venous system and ending in the right atrium. It can be seen and measured in apical 4 chamber view and 2 chamber view also may be seen in long parasternal view Aim: our study aimed to find a relation between the diameter of the coronary sinus and right ventricle (RV) function in patients with dilated cardiomyopathy (DCM). Patients and methods: We evaluated 80 Egyptian individuals and divided them into two major groups, control group (group I) included 30 normal individuals and 50 individuals who had DCM. The DCM group was subdivided into 2 groups, Group II: DCM individuals with impaired RV function (33 individuals) and Group III: DCM individuals with normal RV function (17 individuals). RV dysfunction was determined according to Tricuspid annular plane systolic excursion (TAPSE) <1.7. Results: The diameter and area of the coronary sinus were bigger in the cardiomyopathy group with impaired RV function than in the control and cardiomyopathy groups with normal RV function, and they also had very powerful associations with TR jet velocity, RV MPI, RA areas, RV free longitudinal strain, and TDE-S velocity. In addition, the RA area and IVC diameter were discovered to be independent predictors of CS dilatation. Conclusion: Our findings support our hypothesis that the width of the CS rises as a result of reduced RV function, and we can use the CS diameter as a novel echocardiographic marker to give evidence of decreased RV function in patients with DCM