Variation in Cardiac Vein System is Associated with Coronary Artery Calcium - A Venous-Atherosclerosis Paradox?
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Updated: Mar 22, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Agnieszka Mlynarska1, Rafal Mlynarski2, Maciej Sosnowski3
1Department of Internal Nursing, Chair of Internal Medicine, Medical University of Silesia; ; Department of Electrocardiology; ; Unit of Noninvasive Cardiovascular Diagnostics, Upper Silesian Medical Centre;
Insights
Higher coronary artery calcium scores correlate with more visible cardiac veins. This suggests a link between coronary artery calcification and cardiac venous anatomy variations.
Area of Science:
- Cardiovascular Imaging
- Anatomical Variation
Background:
- Factors influencing cardiac venous anatomy patterns are not fully understood.
- Coronary artery calcium score (CACS) is a marker of atherosclerosis.
Purpose of the Study:
- To investigate the relationship between cardiac venous system variations and the extent of coronary artery calcium.
- To determine if CACS influences the visualization of cardiac veins.
Main Methods:
- Retrospective analysis of 64-slice CT scans from 226 subjects.
- Subjects categorized into three groups based on CACS: 0 AU, 1-100 AU, and >100 AU.
- Cardiac venous system reconstruction during the optimal cardiac cycle phase.
Main Results:
- Higher CACS was associated with improved cardiac vein image quality (p < 0.01).
- The number of visible cardiac veins significantly increased with higher CACS groups (p < 0.001).
- CACS was an independent determinant of visible vein number in multivariate analysis (p < 0.05).
Conclusions:
- A significant association exists between variations in the cardiac venous system and the extent of atherosclerosis.
- Coronary artery calcium score may influence cardiac venous anatomy visualization.
Background:
The factors that determine the different patterns of venous anatomy are not well understood. This study was designed to evaluate the relationship between variation in the cardiac vein system and the extent of coronary artery calcium score (CACS).
Methods:
We reviewed the results of 64-slice CTs of 226 subjects (age 57.2 ± 11.2; 133M) enrolled in our study. The subjects were divided into 3 groups based on coronary artery calcium: 92 patients. with CACS = 0 AU (Agatston Unit, AU); 56 with CACS = 1-100 AU; and 78 patients with CACS > than 100 AU. The cardiac venous system was reconstructed during the optimal phase of the cardiac cycle in each subject.
Results:
Subjects with a higher CACS had a better quality of vein images (p < 0.01). The number of visible veins differed between the groups. Eight subjects (8.7%) in the group with CACS = 0 AU, 7 (12.5%) in the group with CACS = 1-100 AU, and 23 (29.5%) in the group with CACS > 100 AU had five or more visible veins (p < 0.001), whereas the proportion of subjects with less than three visible veins was 56 (60.8%), 31 (55.4%) and 30 (38.4%), respectively (p < 0.05). The number of visible veins correlated with CACS (r = 0.28; p < 0.05). In a multivariate regression analysis, which included age, gender, CACS, LV ejection fraction, myocardial volume and heart rate, the CACS was found to be an independent determinant of the number of visible veins (p < 0.05).
Conclusions:
The results of our study suggested that there is a link between a variation in the cardiac venous system and the extent of atherosclerosis.
Key Words:
Coronary artery calcium score (CACS); Computed tomography; Coronary veins.
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