Echocardiographic characteristics of coronary sinus in patients with arrhythmia and in healthy controls: a single-center clinical study.

BACKGROUND

The coronary sinus (CS) is an anatomical structure that is often targeted in cardiac intervention. Different CS forms may be related to the occurrence of various arrhythmias. This study primarily analyzed whether there are differences in the CS between healthy participants and patients with common arrhythmia.

METHODS

In this cross-sectional study, the relevant information of patients diagnosed with arrhythmia via electrocardiography and that of healthy controls in whom arrhythmia was excluded via electrocardiography in Shandong Provincial Hospital from June 2024 to May 2025 was collected. The CS diameters were measured by tilting the standard apical four-chamber view toward the foot side to display the maximum cross-sectional area of the CS long axis. CS hemodynamic information was acquired at the right ventricular inflow tract view.

RESULTS

The CS ostium diameter of healthy controls was 0.76±0.17 cm, and the normal range was 0.43-1.09 cm. The diameter of the CS ostium in patients with paroxysmal atrial fibrillation (PAF), persistent atrial fibrillation (Pers AF), supraventricular tachycardia (SVT), and frequent premature ventricular contractions (FPVCs) were 0.82±0.17, 1.03±0.22, 0.92±0.34, and 0.83±0.22 cm, respectively. One-way analysis of variance (ANOVA) comparisons revealed statistically significant differences between healthy controls and patients with Pers AF, SVT, and FPVC (P<0.001, P=0.029, and P=0.039, respectively). After matching was performed for sex, age, body surface area (BSA), and right atrial area (RAA), the difference in CS ostium diameter between patients with Pres AF and healthy controls was not statistically significant. However, the morphological difference between healthy controls and patients with SVT and Pers AF was statistically significant (P=0.004 and P=0.015, respectively).

CONCLUSIONS

The diameters of the CS ostium in patients with Pers AF, SVT, and FPVC were increased, which may play a role in the occurrence, maintenance, and recurrence of arrhythmia. Moreover, in patients with SVT and Pers AF, the proportion of wedge-shaped CS was higher than that in healthy controls.