Coronary Sinus Diameter to Inferior Vena Cava Diameter Ratio in the Diagnosis of Cardiac Tamponade: A Novel Approach.


Journal

Journal of computer assisted tomography
ISSN: 1532-3145
Titre abrégé: J Comput Assist Tomogr
Pays: United States
ID NLM: 7703942

Informations de publication

Date de publication:
Historique:
entrez: 23 7 2020
pubmed: 23 7 2020
medline: 30 7 2020
Statut: ppublish

Résumé

In cardiac tamponade, coronary sinus (CS) as an intrapericardial structure can be easily compressed, whereas inferior vena cava (IVC) dilates. This inverse relationship may augment their roles in the evaluation of tamponade imaging. We assessed the usefulness of computerized tomographic measures of CS diameter and also CS/IVC ratio to predict tamponade in clinically stable patients with large pericardial effusion. Sixty-six clinically stable patients who had large pericardial effusions were included. Coronary sinus diameter was measured from the point at 1 cm proximal to the CS ostium. Inferior vena cava diameter was measured from the segment between its right atrial orifice and hepatic vein. Patients with tamponade had smaller CS diameter and CS/IVC ratio. After adjusting with other parameters, only either CS diameter or CS/IVC ratio predicted tamponade, respectively. (Nagelkerke r value for CS was 53.7% and 72.1% for CS/IVC ratio). In Receiver Operating Characteristic Curve analysis, a cutoff value of 6.85 mm for CS diameter had 82.6% sensitivity and 83.7% specificity and a cutoff value of 27% for CS/IVC ratio had 87.0% sensitivity and 86.0% specificity for predicting cardiac tamponade. The tomographic measures of both the CS diameter and the CS/IVC ratio predicted tamponade in clinically stable patients with large pericardial effusion. Compared with CS diameter, CS/IVC ratio seemed to be a more powerful predictor of tamponade.

Sections du résumé

BACKGROUND BACKGROUND
In cardiac tamponade, coronary sinus (CS) as an intrapericardial structure can be easily compressed, whereas inferior vena cava (IVC) dilates. This inverse relationship may augment their roles in the evaluation of tamponade imaging.
AIM OBJECTIVE
We assessed the usefulness of computerized tomographic measures of CS diameter and also CS/IVC ratio to predict tamponade in clinically stable patients with large pericardial effusion.
METHODS METHODS
Sixty-six clinically stable patients who had large pericardial effusions were included. Coronary sinus diameter was measured from the point at 1 cm proximal to the CS ostium. Inferior vena cava diameter was measured from the segment between its right atrial orifice and hepatic vein.
RESULTS RESULTS
Patients with tamponade had smaller CS diameter and CS/IVC ratio. After adjusting with other parameters, only either CS diameter or CS/IVC ratio predicted tamponade, respectively. (Nagelkerke r value for CS was 53.7% and 72.1% for CS/IVC ratio). In Receiver Operating Characteristic Curve analysis, a cutoff value of 6.85 mm for CS diameter had 82.6% sensitivity and 83.7% specificity and a cutoff value of 27% for CS/IVC ratio had 87.0% sensitivity and 86.0% specificity for predicting cardiac tamponade.
CONCLUSIONS CONCLUSIONS
The tomographic measures of both the CS diameter and the CS/IVC ratio predicted tamponade in clinically stable patients with large pericardial effusion. Compared with CS diameter, CS/IVC ratio seemed to be a more powerful predictor of tamponade.

Identifiants

pubmed: 32697531
doi: 10.1097/RCT.0000000000001064
pii: 00004728-202007000-00022
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

599-604

Références

Spodick DH. Acute cardiac tamponade pathologic physiology, diagnosis and management. Prog Cardiovasc Dis. 1967;10:64–96.
Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349:684–690.
Sagar KB, Samuel Wann L, Sidney Klopefenstein H. Echocardiography in the diagnosis of cardiac tamponade. Echocardiography. 1987;4:29–33.
Restrepo CS, Lemos DF, Lemos JA, et al. Imaging findings in cardiac tamponade with emphasis on CT. Radiographics. 2007;27:1595–1610.
Gold MM, Spindola-Franco H, Jain VR, et al. Coronary sinus compression: an early computed tomographic sign of cardiac tamponade. J Comput Assist Tomogr. 2008;32:72–77.
Steiner MA, Marshall JJ. Coronary sinus compression as a sign of cardiac tamponade. Catheter Cardiovasc Interv. 2000;49:455–458.
Sousa-Rodrigues C, Alcântara F, Olave E. Topografía y Biometría del Sistema Venoso Coronario y de sus tributarias. Int J Morphol. 2005;23.
Tubaro M, Vranckx P, Price S, et al. The ESC Textbook of Intensive and Acute Cardiovascular Care. United Kindom: OUP Oxford; 2015.
Hagel KJ. Echocardiographic findings in cardiac tamponade. Acta Med Scand Suppl. 1979;627:217–223.
Armstrong WF, Ryan T, Feigenbaum H. Feigenbaum's Echocardiography. Lippincott Williams & Wilkins; 2010.
Shah SS, Teague SD, Lu JC, et al. Imaging of the coronary sinus: Normal anatomy and congenital abnormalities. Radiographics. 2012;32:991–1008.
Reddy PS, Curtiss EI, Uretsky BF. Spectrum of hemodynamic changes in cardiac tamponade. Am J Cardiol. 1990;66:1487–1491.
Bogaert J, Francone M. Pericardial disease: value of CT and MR imaging. Radiology. 2013;267:340–356.
Rienmüller R, Gröll R, Lipton MJ. CT and MR imaging of pericardial disease. Radiol Clin North Am. 2004;42:587–601.
Killeen KL, Poletti PA, Shanmuganathan K, et al. CT diagnosis of cardiac and pericardial injuries. Emerg Radiol. 1999;6:339–344.
Goldstein L, Mirvis SE, Kostrubiak IS, et al. CT diagnosis of acute pericardial tamponade after blunt chest trauma. Am J Roentgenol. 1989;152:739–741.
Krejci CS, Blackmore CC, Nathens A. Hemopericardium: an emergent finding in a case of blunt cardiac injury. AJR Am J Roentgenol. 2000;175:250.
Harries SR, Fox BM, Roobottom CA. Azygos reflux: a CT sign of cardiac tamponade. Clin Radiol. 1998;53:702–704.
Rotondo A, Scialpi M, Catalano O, et al. Periportal lymphatic distension resulting from cardiac tamponade: CT findings and clinical-pathologic correlation. Emerg Radiol. 1999;6:85–93.
Isaacs D, Hazany S, Gamst A, et al. Evaluation of the coronary sinus on chest computed tomography in patients with and without pulmonary artery hypertension. J Comput Assist Tomogr. 2009;33:513–516.
Williams PL, Warwick R, Dyson M, Bannister LH. Gray's anatomy. 37th ed. Br J Surg. 1989;76:1359–1359.
Felle P, Bannigan JG. Anatomy of the valve of the coronary sinus (Thebesian valve). Clin Anat. 1994;7:10–12.
Chong HH, Plotnick GD. Pericardial effusion and tamponade: evaluation, imaging modalities, and management. Compr Ther. 1995;21:378–385.
Muller L, Bobbia X, Toumi M, et al. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care. 2012;16:R188.
Bendjelid K, Romand J-A, Walder B, et al. Correlation between measured inferior vena cava diameter and right atrial pressure depends on the echocardiographic method used in patients who are mechanically ventilated. J Am Soc Echocardiogr. 2002;15:944–949.
D'Cruz IA, Johns C, Shala MB. Dynamic cyclic changes in coronary sinus caliber in patients with and without congestive heart failure. Am J Cardiol. 1999;83:275–277, A6.

Auteurs

Elif Hande Ozcan Cetin (EH)

From the Cardiology Department, Ankara City Hospital.

Mehmet Serkan Cetin (MS)

Cardiology Clinic, Etimesgut State Hospital, Ankara, Turkey.

Hasan Can Könte (HC)

From the Cardiology Department, Ankara City Hospital.

Bahar Tekin Tak (BT)

From the Cardiology Department, Ankara City Hospital.

Firdevs Aysenur Ekizler (FA)

From the Cardiology Department, Ankara City Hospital.

Fırat Ozcan (F)

From the Cardiology Department, Ankara City Hospital.

Serkan Cay (S)

From the Cardiology Department, Ankara City Hospital.

Ozcan Ozeke (O)

From the Cardiology Department, Ankara City Hospital.

Burak Akcay (B)

From the Cardiology Department, Ankara City Hospital.

Serkan Topaloglu (S)

From the Cardiology Department, Ankara City Hospital.

Dursun Aras (D)

From the Cardiology Department, Ankara City Hospital.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH