Echocardiographic Assessment of Coronary Sinus Blood Flow in Coronary Artery Disease: Clinical Implications and Diagnostic Value

Abstract Background: Coronary artery disease (CAD) is a major health issue contributing to a significant number of sudden deaths. Detection of coronary artery stenosis using noninvasive techniques measuring coronary sinus blood flow (CSBF) can aid in decision-making regarding the need for intervention. Hence, exploring the role of CSBF, as measured using transthoracic echocardiography (TTE), in predicting the severity of coronary artery disease is essential. Materials and Methods: An observational case–control study was conducted among 70 cases of coronary artery disease and 70 matched controls, based on age and sex. The coronary sinus velocity time integral (CS-VTI), mean velocity, mean gradient, diameter, CSBF per beat, and CSBF per minute were measured among the two groups using TTE and compared using a t -test. The correlation between CSBF and the modified Gensini score (mGS) was assessed, and the cutoff value for predicting CAD was evaluated using the receiver operating characteristic (ROC) curve. Results: There was a statistically significant difference in the mean values of coronary sinus diameter, CSBF per beat, and CSBF per minute, but not for CS-VTI, mean velocity, and mean gradient. ROC curve predicted a cutoff value of 3.7 and 263.9 for CSBF/beat and CSBF/minute, respectively in diagnosing signifiicant CAD. Conclusion: Assessing the CSBF using TTE is noninvasive technique with good correlation with mGS and thus can be used to assess the severity of CAD and decide on the necessary intervention.