The coronary circulation is a complex system in which vascular resistances are determined by an interplay of forces in at least three compartments: the epicardial, the microvascular, and the venous district. Cardiologists, and particularly interventional cardiologists, normallly place the focus oftheir attention on diseases of the epicardial coronary circulation as possible causes of coronary syndromes and neglect the importance of the other two compartments of coronary circulation. The study of the coronary microcirculation, an increasingly recognized source of ischemia, has long been disregarded, but is witnessing a revival since the (re-)introduction of diagnostic tools in the better equipped catheterization laboratories. Unfortunately, to date our understanding of coronary microvascular disease remains incomplete and the numerous proposed classifications fail to reflect its complexity. Further, no specific therapy for these disorders is available. The coronary venous circulation is an even more neglected third vascular district. Its role in regulating coronary resistances is almost completely unexplored, but inital evidence suggests that the modulation of venous pressure might help improve coronary perfusion. Coronary sinus interventions are a group of invasive techniques (both surgical and catheter-based) that are designed to treat ischaemic heart disease by increasing coronary venous pressure and therefore redistributing coronary blood flow towards the endocardium. In this review paper, we revise the role of these interventions with particular focus on acute and chronic coronary microvascular disease.

中文翻译：

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冠状静脉治疗改善微血管功能障碍

冠状动脉循环是一个复杂的系统，其中血管阻力由至少三个区室中力的相互作用决定：心外膜、微血管和静脉区。心脏病专家，尤其是介入心脏病专家，通常将注意力集中在可能导致冠状动脉综合征的心外膜冠状循环疾病上，而忽略了冠状循环其他两个区室的重要性。冠状动脉微循环研究是一种越来越被认可的缺血来源，长期以来一直被忽视，但自从（重新）引入诊断工具在装备更好的导管插入实验室中以来，冠状动脉微循环的研究正在复苏。很遗憾，迄今为止，我们对冠状动脉微血管疾病的理解仍然不完整，许多提议的分类未能反映其复杂性。此外，没有针对这些疾病的特定疗法可用。冠状静脉循环是一个更容易被忽视的第三血管区。它在调节冠状动脉阻力方面的作用几乎完全没有被探索过，但初步证据表明，静脉压的调节可能有助于改善冠状动脉灌注。冠状窦介入术是一组侵入性技术（基于手术和导管），旨在通过增加冠状静脉压力来治疗缺血性心脏病，从而将冠状动脉血流重新分配到心内膜。在这篇综述论文中，