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The impact of the coronary sinus reducer upon left ventricular function in patients with refractory angina pectoris

Georgios Tzanis1, Anna Palmisano2, Guglielmo Gallone1

  • 1Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 3, 2019
PubMed

Insights

Coronary sinus (CS) Reducer implantation significantly improved left ventricular ejection fraction and reduced volumes in patients with refractory angina. These improvements were more pronounced in patients with reduced ejection fraction, suggesting enhanced myocardial perfusion.

Area of Science:

  • Cardiology
  • Cardiovascular Interventions
  • Cardiac Imaging

Background:

  • Coronary sinus (CS) Reducer implantation is established for symptomatic relief in refractory angina.
  • The impact of CS Reducer on left ventricular (LV) function remains incompletely understood.

Purpose of the Study:

  • To evaluate the effects of CS Reducer implantation on left ventricular (LV) function and myocardial perfusion.

Main Methods:

  • Cardiac magnetic resonance (CMR) was used to assess LV volumes and ejection fraction (LVEF) pre- and post-implantation.
  • Stress CMR was performed to measure myocardial perfusion reserve index (MPRI).

Main Results:

  • Successful Reducer implantation in 19 patients led to significant improvements in LVEF and reductions in LV end-diastolic and end-systolic volumes.
  • Patients with reduced baseline LVEF (<50%) showed a greater increase in LVEF and a more substantial decrease in LV end-systolic volume.
  • A significant increase in transmural MPRI was observed 4 months post-implantation.

Conclusions:

  • CS Reducer implantation improves LV function and reduces adverse LV remodeling in patients with refractory angina.
  • The benefits are more pronounced in patients with pre-existing reduced ejection fraction.
  • Enhanced myocardial perfusion may underlie the observed functional improvements.
Abstract

Keywords:
cardiac magnetic resonancecoronary sinus reducerischemic cardiomyopathyrefractory anginaremodeling

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