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Objective <p>The coronary sinus (CS) can reflect the pressure and volume load of the right heart chambers. Idiopathic pulmonary arterial hypertension (IPAH) is a&#xa0;progressive, life-threatening disease in which risk assessment plays a&#xa0;critical role. We aimed to evaluate (a) the correlation between CS diameter and risk assessment parameters in IPAH patients and (b) the utility of CS diameter in predicting mortality and hospitalization.</p> Methods <p>This retrospective study included 25&#xa0;IPAH patients. All patients underwent echocardiographic and laboratory examinations, 6‑minute walk test, and cardiopulmonary exercise test on the same day. The follow-up was 16.8 ± 10.1&#xa0;months. The primary endpoint was mortality or hospitalization. The relationship between CS diameter, established risk parameters, and prognosis was analyzed.</p> Results <p>Six patients (24%) were hospitalized, and three patients (12%) died during the follow-up . The mean CS diameter was 9.9 ± 3.7 mm and showed a&#xa0;moderate positive correlation with age (<i>r</i> = 0.560, <i>p</i> = 0.004) and NT-proBNP levels (<i>r</i> = 0.625, <i>p</i> = 0.001); a&#xa0;weak positive correlation with functional class (<i>r</i> = 0.483, <i>p</i> = 0.017); and moderate negative correlations with 6‑min walking distance (<i>r</i> = −0.553, <i>p</i> = 0.005) and peak oxygen uptake (<i>r</i> = −0.506, <i>p</i> = 0.038). Greater CS diameter was associated with older age, higher NT-proBNP levels, and worse functional class, while reduced exercise capacity and peak VO<sub>2</sub> were accompanied by increased CS diameter. A&#xa0;CS diameter &gt; 9 mm predicted mortality and hospitalization with a&#xa0;sensitivity of 77.8% and specificity of 75.0% (area under the curve [AUC]: 0.788; 95% CI: 0.580–0.996; <i>p</i> = 0.019). The Kaplan–Meier curve showed that as CS diameter increased, mortality and hospitalization rates increased significantly.</p> Conclusion <p>The CS diameter is a&#xa0;simple, readily available, noninvasive echocardiographic parameter that may be a&#xa0;valuable adjunct to current risk assessment models in IPAH.</p>

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Role of the coronary sinus in risk stratification and prognostic evaluation of idiopathic pulmonary arterial hypertension

  • 期刊论文

  • 发表日期：

    2025年9月22日

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  • Begum Uygur,
  • Kadriye Memiç Sancar,
  • Ümit Bulut,
  • Serkan Kahraman,
  • Alkım Ateşli Yazıcı,
  • Ali Rıza Demir,
  • Hicaz Zencirkıran Ağuş,
  • Gizemnur Coşkun,
  • Mehmet Erturk,
  • Mustafa Yıldız

摘要

Objective

The coronary sinus (CS) can reflect the pressure and volume load of the right heart chambers. Idiopathic pulmonary arterial hypertension (IPAH) is a progressive, life-threatening disease in which risk assessment plays a critical role. We aimed to evaluate (a) the correlation between CS diameter and risk assessment parameters in IPAH patients and (b) the utility of CS diameter in predicting mortality and hospitalization.

Methods

This retrospective study included 25 IPAH patients. All patients underwent echocardiographic and laboratory examinations, 6‑minute walk test, and cardiopulmonary exercise test on the same day. The follow-up was 16.8 ± 10.1 months. The primary endpoint was mortality or hospitalization. The relationship between CS diameter, established risk parameters, and prognosis was analyzed.

Results

Six patients (24%) were hospitalized, and three patients (12%) died during the follow-up . The mean CS diameter was 9.9 ± 3.7 mm and showed a moderate positive correlation with age (r = 0.560, p = 0.004) and NT-proBNP levels (r = 0.625, p = 0.001); a weak positive correlation with functional class (r = 0.483, p = 0.017); and moderate negative correlations with 6‑min walking distance (r = −0.553, p = 0.005) and peak oxygen uptake (r = −0.506, p = 0.038). Greater CS diameter was associated with older age, higher NT-proBNP levels, and worse functional class, while reduced exercise capacity and peak VO2 were accompanied by increased CS diameter. A CS diameter > 9 mm predicted mortality and hospitalization with a sensitivity of 77.8% and specificity of 75.0% (area under the curve [AUC]: 0.788; 95% CI: 0.580–0.996; p = 0.019). The Kaplan–Meier curve showed that as CS diameter increased, mortality and hospitalization rates increased significantly.

Conclusion

The CS diameter is a simple, readily available, noninvasive echocardiographic parameter that may be a valuable adjunct to current risk assessment models in IPAH.