Non-invasive Diagnosis of Coronary Microvascular Disease: Pilot Study

Launched by UNIVERSITY OF LEICESTER · Oct 1, 2023

Keywords

ClinConnect Summary

This clinical trial is exploring a new way to diagnose coronary microvascular disease (CMD), which can cause chest pain in patients who don't have significant blockages in their main heart arteries. About 60% of people with stable chest pain have CMD, where the tiny blood vessels in the heart don't supply enough blood for the heart's needs. Currently, diagnosing this condition requires an invasive test called a coronary angiogram, which can be uncomfortable and carries some risks. The goal of this study is to see if newer imaging techniques using CT and MRI scans can effectively identify CMD without needing invasive procedures.

To participate, individuals must be at least 18 years old, currently involved in another study called 'CMR versus CT-FFR in CAD', and be referred for an invasive coronary angiogram due to chest pain. Participants will undergo additional tests during their angiogram, including an MRI scan that may involve exercise. The findings from these non-invasive tests will be compared to the results of the invasive tests to determine if they can reliably diagnose CMD. If you or a loved one are eligible, this trial could help improve the understanding and treatment of microvascular angina, potentially benefiting many patients in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Current participant of the 'CMR versus CT-FFR in CAD' study
• * Continue to meet the inclusion criteria for the main study:
• • Patients aged ≥18 years
• • Referred for invasive coronary angiography for investigation of chest pain
• • Willing and able to give informed consent
• • Willing and able (in the Investigators opinion) to comply with all study requirements.
• • Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the study.
• • Able to understand written English
• • Able to perform exercise in the MRI scanner
• Study arm:
• • No evidence of obstructive or non-obstructive CAD on research CTCA
• • Myocardial perfusion defect detected on adenosine stress CMR indicative of CMD
• Control arm:
• • • Evidence of multivessel CAD on research CTCA
• Exclusion Criteria:
• * Meet the exclusion criteria for the main study:
• • Recent acute coronary syndrome (\< 6 months)
• • Severe claustrophobia
• • Absolute contraindications to CMR - those with MR conditional or safe devices will be included
• • Second-/third-degree atrioventricular block
• • Severe chronic obstructive pulmonary disease
• • Moderate-severe asthma
• • Estimated glomerular filtration rate \<30 ml/min/1.73m2
• • Women who are pregnant, breast-feeding or of child-bearing potential (premenopausal women)
• • Contraindication to iodinated contrast
• • Participants who have participated in a research study involving an investigational product in the past 12 weeks
• • Patients unable to understand written English