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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Coronary Sinus Narrowing for the Treatment of Patients With Angina and Evidence of Microvascular Dysfunction: A

Maayan Konigstein1, Itamar Loewenstein1, Ophir Freund2

  • 1Department of Cardiology, Tel Aviv Sourasky University Medical Center (Ichilov), Tel Aviv, Israel; Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

The Canadian Journal of Cardiology
|June 17, 2026
PubMed

Insights

Coronary sinus Reducer implantation improved microvascular function and quality of life in patients with refractory angina and coronary microvascular dysfunction (CMD). This therapy offers significant relief for challenging angina cases.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Coronary microvascular dysfunction (CMD) causes refractory angina, a challenging clinical condition.
  • Coronary sinus Reducer implantation is a recognized therapy for obstructive coronary artery disease (CAD).
  • This study investigates the Reducer's efficacy in patients with angina and CMD.

Purpose of the Study:

  • To evaluate the impact of Reducer implantation on microvascular function in patients with angina and CMD.
  • To assess improvements in angina severity, functional capacity, and quality of life post-implantation.

Main Methods:

  • Forty patients with refractory angina, non-obstructive CAD, and CMD underwent Reducer implantation.
  • Invasive microvascular function tests (IMR, CFR, RRR, MRR) were performed at baseline and 4 months.
  • Angina symptoms (CCS class), functional capacity (6mWT), and quality of life (SAQ) were assessed pre- and post-procedure.

Main Results:

  • Significant improvements were observed in IMR, CFR, RRR, and MRR at 4 months post-implantation (p<0.001).
  • Canadian Cardiovascular Society (CCS) class improved from III to II.
  • Seattle Angina Questionnaire (SAQ) scores and 6-minute walk test (6mWT) distance showed significant improvements (p<0.05).

Conclusions:

  • Reducer implantation effectively enhances coronary microvascular function.
  • The procedure leads to significant reductions in angina symptoms.
  • Patients experience improved functional capacity and quality of life after Reducer implantation.
Abstract

Keywords:
Coronary sinus Reduceranginaangina with nonobstructive coronary arteriescoronary physiologymicrovascular dysfunctionquality of life

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