CORONARY VENOUS SYSTEM DISEASES

Coronary_Venous_System_Diseases

CORONARY VENOUS SYSTEM, HEART FAILURE AND CORONARY ARTERY DISEASE

Uğur Özpınar1 Ahmet Barutçu2

1Çanakkale Mehmet Akif Ersoy State Hospital, Department of Cardiology, Çanakkale, Türkiye

2Çanakkale Onsekiz Mart University, Faculty of Medicine , Department of Cardiology, Çanakkale, Türkiye

Özpınar U, Barutçu A. Coronary Venous System, Heart Failure and Coronary Artery Disease. In: Altay S, Akşit E, Kemaloğlu Öz T editor. Coronary Venous System Diseases. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.85-89.

ABSTRACT

Recent evidence highlights the coronary venous system (CVS) as a rather dynamic entity than as a passive anatomical conduit, with critical implications in both coronary artery disease (CAD) and heart failure (HF). A full comprehension of the pathophysiological interplay between certain coro- nary venous dynamics and myocardial ischemia offers a new perspective in thoroughly evaluating and managing certain cardiovascular diseases. Elevated coronary sinus pressure, impaired venous drain- age, and resultant venous congestion have been increasingly recognized as meaningful contributors to myocardial dysfunction, ischemia, and adverse cardiac remodeling. In this setting, strategies focused on the coronary venous system, such as the coronary sinus reducer device, are seen as viable treatments for those who have refractory angina and chronic myocardial ischemia, showing better clinical results and life quality. In heart failure patients, alterations in coronary venous hemodynamics may influence myocardial perfusion as well as ventricular function. This represents a potential therapeutic target, thus affecting clinical prognosis. This chapter almost comprehensively reviews some anatomical and phys- iological characteristics within the coronary venous system, elucidates its relationship with coronary artery disease plus heart failure, and explores certain contemporary therapeutic applications, including the clinical role for the coronary sinus reducer device. Also, the present literature derived from certain clinical trials and expert consensus documents is summarized to give an evidence-based understanding of the importance and clinical utility of targeting the coronary venous system in cardiology practice.

Keywords: Coronary artery disease; Heart failure; Myocardial infarction; Myocardial ischemia; Ventricular remodeling

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