Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Interventional Cardiology Department, Henry Dunant Hospital Center, Athens, Greece.
Catheter Cardiovasc Interv. 2021 Sep;98(3):E365-E369. doi: 10.1002/ccd.29699. Epub 2021 Apr 14.
Coronary sinus (CS) reducer implantation is associated with symptomatic relief of patients with refractory angina. However, 15% to 30% of the patients do not respond to this treatment. Aim if this study was to evaluate the effect of CS size in the effectiveness of the device.
Prior to device implantation and at 4-month resting ventricular function was assessed by stress cardiac magnetic resonance. Ischemia was assessed by the myocardial perfusion reserve index (MPRI).
Fifteen patients (66 ± 10 years) underwent successful CS Reducer implantation, with improvements in angina class and exercise tolerance. Patients with a smaller CS size (<5.8 mm) presented a significantly higher percentage increase in MPRI (63 ± 51 vs 9 ± 30%, P = .03) and a higher reduction in left ventricle end-diastolic volumes.
Greater benefits, in terms of ischemia improvement, after CS Reducer implantation were seen in patients with smaller CS sizes, suggesting a potential mechanism underlying the observed rates of reducer non-responsiveness.
冠状窦（CS）减容植入术与难治性心绞痛患者症状缓解相关。然而，仍有 15%至 30%的患者对该治疗无反应。本研究旨在评估 CS 大小对该设备有效性的影响。
在装置植入前和 4 个月静息心室功能通过应激心脏磁共振进行评估。通过心肌灌注储备指数（MPRI）评估缺血情况。
15 名患者（66±10 岁）成功接受 CS 减容植入术，心绞痛分级和运动耐量均有所改善。CS 较小（<5.8mm）的患者 MPRI 增加百分比显著更高（63±51% vs 9±30%，P=0.03），左心室舒张末期容积降低更多。
CS 减容植入术后 CS 较小的患者缺血改善获益更大，提示观察到的减容无反应率的潜在机制。
