The Relationship of Coronary Sinus Dilation with Pulmonary Artery Pressure in Pediatric Patients

Background: Increased right atrial pressure due to pulmonary hypertension may impair venous drainage with resultant coronary sinus dilatation. The aim of this study was to search for correlations between coronary sinus diameter and estimated pulmonary artery pressure in children.

Methods: In a prospective study, 100 children who were referred consecutively for transthoracic echocardiography were included in this study. Ratios of coronary sinus diameter to weight, body surface area and aortic annulus were calculated for in each patient. Correlation between coronary sinus diameter and estimated pulmonary artery pressure was studied by person correlation. A tricuspid regurgitation peak gradient more than 36 mmHg or pulmonary regurgitation peak gradient more than 25 mmHg were considered as pulmonary hypertension.

Results: Sixty-eight of our participants had no pulmonary hypertension and 32 did. Mean age was 7.6 years in the patients without pulmonary hypertension and 8.0 years in the patients with pulmonary hypertension (P=0.11). Mean coronary sinus diameter to aortic annulus diameter ratio was 0.49 ± 0.13 in the patient with pulmonary hypertension versus 0.38 ± 0.12 in the patient without pulmonary hypertension (P<0.001). The coronary sinus diameter to body surface area ratio was 1.3 ± 0.59 versus 0.7 ± 0.28 (P<0.001), and coronary sinus diameter to weight ratio was 0.06 ± 0.03 versus 0.02 ± 0.01 (P<0.001).

Conclusion: coronary sinus dilation was documented in pediatric patients with pulmonary hypertension. The ratios of coronary sinus diameter to aortic annulus diameter, body surface area and weight correlated significantly with pulmonary hypertension.