Megha Prasad, Maayan Konigstein, Ranil de-Silva, Amir Lerman, Shmuel Banai
{"title":"冠状窦狭窄缓解心肌缺血和改善心绞痛的原理。","authors":"Megha Prasad, Maayan Konigstein, Ranil de-Silva, Amir Lerman, Shmuel Banai","doi":"10.1016/j.amjcard.2025.08.066","DOIUrl":null,"url":null,"abstract":"<p><p>Effective therapy for patients suffering from refractory angina remains a major unmet need. Chronic angina, which is refractory to medical and interventional therapies, affects patients who are not suitable for revascularization, patients following successful revascularization, and patients with coronary microvascular dysfunction. Coronary sinus (CS) narrowing has been studied as a potential therapy for patients with angina. Pre-clinical and clinical data, including 2 randomized sham-controlled clinical trials and 2 large prospective multi-center registries, have confirmed the safety and effectiveness of CS narrowing in patients with refractory angina due to obstructive coronary artery disease (CAD). Preliminary pathophysiologic studies suggest that CS narrowing may also improve coronary microvascular function and alleviate microvascular angina. Here, we review the historical perspective, mechanism of action, and clinical applications of CS narrowing. In Conclusion: With the accumulation of new data, the time is ripe to revisit the therapeutic benefits seen in historical CS interventions and demonstrated in recent clinical research to reduce angina and ischemia and improve quality of life of patients with disabling refractory angina.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"128-133"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Principles of Coronary Sinus Narrowing to Relieve Myocardial Ischemia and Improve Angina.\",\"authors\":\"Megha Prasad, Maayan Konigstein, Ranil de-Silva, Amir Lerman, Shmuel Banai\",\"doi\":\"10.1016/j.amjcard.2025.08.066\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Effective therapy for patients suffering from refractory angina remains a major unmet need. Chronic angina, which is refractory to medical and interventional therapies, affects patients who are not suitable for revascularization, patients following successful revascularization, and patients with coronary microvascular dysfunction. Coronary sinus (CS) narrowing has been studied as a potential therapy for patients with angina. Pre-clinical and clinical data, including 2 randomized sham-controlled clinical trials and 2 large prospective multi-center registries, have confirmed the safety and effectiveness of CS narrowing in patients with refractory angina due to obstructive coronary artery disease (CAD). Preliminary pathophysiologic studies suggest that CS narrowing may also improve coronary microvascular function and alleviate microvascular angina. Here, we review the historical perspective, mechanism of action, and clinical applications of CS narrowing. In Conclusion: With the accumulation of new data, the time is ripe to revisit the therapeutic benefits seen in historical CS interventions and demonstrated in recent clinical research to reduce angina and ischemia and improve quality of life of patients with disabling refractory angina.</p>\",\"PeriodicalId\":7705,\"journal\":{\"name\":\"American Journal of Cardiology\",\"volume\":\" \",\"pages\":\"128-133\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjcard.2025.08.066\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjcard.2025.08.066","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Principles of Coronary Sinus Narrowing to Relieve Myocardial Ischemia and Improve Angina.
Effective therapy for patients suffering from refractory angina remains a major unmet need. Chronic angina, which is refractory to medical and interventional therapies, affects patients who are not suitable for revascularization, patients following successful revascularization, and patients with coronary microvascular dysfunction. Coronary sinus (CS) narrowing has been studied as a potential therapy for patients with angina. Pre-clinical and clinical data, including 2 randomized sham-controlled clinical trials and 2 large prospective multi-center registries, have confirmed the safety and effectiveness of CS narrowing in patients with refractory angina due to obstructive coronary artery disease (CAD). Preliminary pathophysiologic studies suggest that CS narrowing may also improve coronary microvascular function and alleviate microvascular angina. Here, we review the historical perspective, mechanism of action, and clinical applications of CS narrowing. In Conclusion: With the accumulation of new data, the time is ripe to revisit the therapeutic benefits seen in historical CS interventions and demonstrated in recent clinical research to reduce angina and ischemia and improve quality of life of patients with disabling refractory angina.
期刊介绍:
Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.