CORONARY VENOUS SYSTEM DISEASES

Coronary_Venous_System_Diseases

CORONARY VENOUS SYSTEMAND PULMONARY HYPERTENSION

Çağlar Kaya

Trakya University, Faculty of Medicine, Department of Cardiology, Edirne, Türkiye

Kaya Ç. Coronary Venous System and Pulmonary Hypertension. In: Altay S, Akşit E, Kemaloğlu Öz T editor. Coronary Venous System Diseases. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.91-96.

ABSTRACT

The coronary venous system (CVS), once considered a passive component of cardiac circulation, has gained significant attention in the context of pulmonary hypertension (PH). The coronary sinus (CS), the main conduit of the CVS, reflects elevated right atrial pressure (RAP) resulting from right ven- tricular overload. CS dilatation, measurable via echocardiography or advanced imaging modalities, is correlated with RAP and may serve as a non-invasive prognostic marker. Experimental studies have demonstrated dynamic regulation of CS pressure and resistance through vagal stimulation and phar- macologic agents. Anatomical variants of CS and its valves can complicate interventional procedures such as cardiac resynchronization therapy. Additionally, myocardial sleeves surrounding the CS may contribute to atrial arrhythmogenesis in PH. CT and MR imaging have enabled detailed anatomical mapping of the CVS. Persistent left superior vena cava and unroofed CS are congenital anomalies that can mimic PH-induced CS dilatation. A comprehensive understanding of CS physiology and pathology enhances diagnostic accuracy and procedural planning. Future research should investigate CS-targeted therapies and standardize CS-based markers in PH management.

Keywords: Coronary venous system; Pulmonary hypertension; Coronary sinus

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