1. Department of Interventional Cardiology, Henry Dunant Hospital Center, Athens, Greece; 2. Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy
The study by Zivelonghi et al1 evaluated for the first time the effect of the coronary sinus reducer (CSR) in the exercise capacity of patients with chronic angina. Patients’ peak oxygen uptake (VO2peak) increased by 11%, six months after CSR implantation, suggesting a possible reduction of myocardial ischaemia. Indeed, we have recently demonstrated in a stress cardiac magnetic resonance (CMR)-based study that CSR decreased the ischaemic burden, providing a physiological rationale underlying its efficacy2. However, there are some concerns that should be taken into account to evaluate the results of this study.