Angiographic functional characterization of the coronary sinus

Background: Coronary sinus is a venous conduit with dynamic and unclear function with regard to coronary circulation. Objectives: To describe the dynamic changes of the coronary sinus during the cardiac cycle. Methods: The angiographic feature of the coronary sinus was evaluated in 30 patients undergoing diagnostic and therapeutic coronary angiography. Results: Prolonged angiographic imaging following coronary injections permitted accurate demonstration of the coronary sinus in all 30 patients. We report, for the first time, that the coronary sinus can be divided into two angiographic functional/anatomic portions, upper and lower. The lower part is prone to a highly dynamic contraction/relaxation pattern, observed in 12 of the 30 patients, while 10 patients had normal and 8 had low contractile pattern on angiography. Clinical assessment of these patients did not identify an association with this motion pattern. Conclusions: The coronary sinus is an important anatomic/functional structure that should be her investigated in patients with various forms of heart disease.