Endothelial Dysfunction

This research aims to explore the relationship between changes in the small blood vessels in the eye and coronary microvascular dysfunction (CMD), a condition linked to angina and heart ischemia without blocked large coronary arteries. CMD increases the risk of serious heart problems, but current tests to assess it can be costly, involve radiation, or take a long time. The study will use a new optical imaging technology called optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) to non-invasively examine the eye's microcirculation and compare it with coronary microcirculation measured by a coronary angiography-derived index of microvascular resistance (caIMR).

This research aims to understand how menopause affects the risk of cardiovascular diseases such as atherosclerosis, heart attacks, and strokes in women. It focuses on the time around menopause when estrogen production stops, which is linked to a higher risk of these conditions. The study will follow 200 women from before menopause to at least 10 years after, using advanced methods to observe changes in blood vessels, the heart, and the brain, along with microRNA analysis of blood and tissue samples. Participants will be observed over a long period with repeated assessments before menopause and at 1, 3, 5, 10, and 20 years after menopause. These assessments include invasive and non-invasive measures of vascular function, as well as monitoring changes in skeletal muscle proteins and RNA expression from muscle and blood samples. Blood pressure will also be tracked regularly during this time. Women involved in the study will undergo detailed cardiovascular and biological evaluations at various time points throughout the study. This includes tests of blood vessel function, muscle tissue analysis, and blood sample collections. The researchers will also monitor blood pressure and other health indicators to understand the long-term impact of menopause on cardiovascular health. The total participation may last over 20 years, providing extensive data on how menopause influences disease risk over time.

Researchers are evaluating the effects of a smartphone-based Healthy Lifestyle (HLS) intervention on the mental and physical health of firefighters in Tainan, Taiwan. This cluster randomized controlled trial aims to determine if the Traditional Chinese version of the HLS mobile app can improve firefighters' health compared to usual care. The study also seeks to find out whether the intervention can promote a healthier lifestyle and reduce the risk of chronic non-communicable diseases among firefighters. Participants will be randomly assigned to either the intervention group, which uses the Traditional Chinese HLS mobile app designed specifically for firefighters, or the control group, which receives usual care. The intervention period lasts from 3 to 6 months, during which firefighters in the intervention group will use the app to support healthier behaviors. The control group will continue with their standard practices without the app. Throughout the study, firefighters will undergo health and fitness assessments at the start and again 3 to 6 months after the intervention begins. Measurements include blood pressure, depressive symptoms, PTSD symptoms, body mass index, smoking habits, diet patterns, physical activity levels, sitting time, sleep duration and napping frequency, glycated hemoglobin, lipid profiles, C-reactive protein, and physical performance. The study will monitor these outcomes to assess changes in mental and physical health. Safety and progress will be observed through these regular evaluations during the study period.

Researchers are evaluating non-invasive imaging methods to assess skin blood flow dynamics. This study aims to test and validate how well these imaging technologies perform by using a pressure cuff to create changes in blood flow, ranging from low flow (ischemic) to high flow (hyperemic). The focus is on establishing the basic feasibility of these imaging tools in detecting vascular changes. The study uses Multi-Spectral Imaging and Laser Speckle Imaging, both non-contact optical devices. Multi-Spectral Imaging measures concentrations of total, deoxygenated, and oxygenated hemoglobin in tissue, while Laser Speckle Imaging measures relative blood flow at different times. A pressure cuff occlusion is applied to stimulate changes in blood flow for these devices to detect. Participants will be observed using these imaging methods during vascular occlusion procedures. The main outcome measured is skin blood flow over a 4-week period. The study includes healthy volunteers aged 18 and older and involves non-invasive tests without treatment. Researchers will monitor blood flow changes and the performance of the imaging devices during the study period, which began in 2011 and is expected to continue until 2028.

Researchers are evaluating the use of dapagliflozin to reduce cardiovascular risk in women who have experienced hypertensive pregnancies. This randomized, placebo-controlled trial focuses on patients at high risk for adverse cardiovascular outcomes within five years after delivery. The study is a pilot-scale, single institution investigation aiming to assess the feasibility, acceptability, and effects of dapagliflozin during the postpartum period. Participants will be randomly assigned to one of two groups: one group will receive dapagliflozin 10 mg daily for six months, while the other group will receive a daily placebo for the same duration. During the study, participants will attend four study visits and complete specific activities including daily blood pressure monitoring, weekly weight measurements, laboratory tests, and echocardiograms. After the six-month treatment period, participants will be followed remotely for one month. Throughout the trial, researchers will measure cardiovascular risk reduction scores at the start and after six months of treatment. Secondary outcomes include tracking patient adherence, barriers to adherence, loss to follow-up rates, and screening statistics over a two-year recruitment period. The total participation includes treatment and follow-up visits, with regular assessments to monitor health and gather data for evaluating the study drugs' impact on cardiovascular risk.

Researchers are evaluating the effect of coronary sinus (CS) reducer implantation in patients who have heart failure with preserved ejection fraction (HFpEF) combined with coronary microvascular dysfunction (CMD). The study aims to measure myocardial ischemia by using stress myocardial perfusion assessed through cardiovascular magnetic resonance (CMR). This observational research is sponsored by the Mayo Clinic and focuses on patients with these specific heart conditions. Participants diagnosed with HFpEF, non-obstructive coronary artery disease, and documented CMD will undergo a 50-minute non-invasive stress perfusion CMR test. The study involves observing changes in heart muscle blood flow by measuring the endocardial to epicardial perfusion ratio at the start and after 6 months. This diagnostic approach helps researchers understand how the CS reducer may influence heart muscle perfusion. Throughout the study, participants will be involved in CMR imaging sessions to assess heart function and blood flow under stress conditions. The primary outcome measured is the change in the endocardial to epicardial perfusion ratio between baseline and 6 months. Patients must consent to participate and be enrolled in the main CS reducer HFpEF study. The total duration includes initial imaging and follow-up after six months to monitor changes.

Researchers are evaluating patients with coronary heart disease who have high-risk plaques identified by computed tomography angiography (CTA) and are scheduled for percutaneous coronary intervention (PCI). The study aims to compare the effects of bivalirudin and standard heparin anticoagulation therapies on coronary microvascular dysfunction (CMD) following PCI. This research includes measuring post-PCI blood flow and heart muscle damage markers to explore potential improvements in microcirculation and long-term heart outcomes. Participants will be randomly assigned to one of two groups during their PCI procedure: one group will receive bivalirudin, starting with a single intravenous dose of 0.75 mg/kg followed by a continuous infusion of 1.75 mg/kg per hour for 4 hours after PCI; the other group will receive a single intravenous dose of 50 U/kg of standard heparin. The study includes a follow-up period of 6 months to monitor clinical events and heart function. The research also investigates how bivalirudin might protect the heart by examining related biomarkers. During the study, participants will undergo assessments including coronary angiography-derived index of microcirculatory resistance (CaIMR), blood flow grading, frame count corrections, myocardial perfusion grading, and troponin level measurements. Imaging evaluations and biomarkers related to endothelial function and myocardial injury will be collected within 3 days after PCI. Researchers will track major adverse cardiac events over 6 months. The trial is designed to monitor safety and effectiveness of treatments throughout the study period, with participation lasting approximately 6 months post-procedure.

Researchers are conducting a randomized, single-blind, multi-center, placebo-controlled Phase 2a trial to study BX-001N in preventing acute kidney injury related to cardiac surgery and subsequent major adverse kidney events. The study aims to evaluate the efficacy and safety of BX-001N in approximately 40 adult participants undergoing cardiac surgery involving total circulatory arrest. Participants will be randomly assigned to one of three groups: two experimental groups receiving either low or high doses of BX-001N intravenously once daily for three days, and a placebo group receiving matching placebo injections on the same schedule. Hospitalization occurs from one day before surgery through Day 7, with the investigational product administered during this period. Participants will have follow-up visits up to Day 90 to assess safety and efficacy. Assessments include monitoring kidney injury biomarkers such as NGAL, serum creatinine, eGFR, and other related markers from baseline through specified days. Researchers will also track major adverse renal events and kidney function changes. Safety and treatment adherence will be closely monitored throughout the study.

Researchers are studying how a special English Breakfast tea enriched with fermented brown seaweed might help improve cardiovascular health in postmenopausal women. The study focuses on factors like blood pressure, vascular function, and markers of cardiovascular risk because cardiovascular risk increases after menopause. Brown seaweed contains antioxidants, pigments, and fiber that may benefit heart health. Participants will be randomly assigned to drink either the enriched tea or a regular control tea three times a day for eight weeks. Each tea bag contains 3 grams of tea, with the enriched version also having 1 gram of fermented seaweed. They will prepare each cup by brewing the tea in boiling water for three minutes. The study uses a double-blind design, so neither participants nor researchers know which tea is given until the trial ends. Participants will attend two visits, one at the start and one after eight weeks, to measure blood pressure continuously and assess vascular function, blood lipids, insulin resistance, and menopause symptoms. Researchers will track compliance through tea logs and leftover tea bag counts, and contact participants regularly to support adherence. The total study duration for each participant is about eight weeks, with detailed health assessments performed before and after the intervention.

Heart disease is the leading cause of death worldwide, contributing to 16% of global fatalities and imposing a significant economic burden, especially as the population ages. Some patients with heart disease experience symptoms not relieved by medications and require coronary artery bypass graft (CABG) surgery. Although CABG can improve chest pain and has life-prolonging potential, it may increase inflammation and is often accompanied by high levels of anxiety and depression around the time of surgery, which can affect health outcomes and quality of life. This trial is a randomized controlled feasibility study comparing a brief, two-session telehealth Acceptance and Commitment Therapy (ACT) intervention to treatment as usual for patients undergoing CABG surgery. The ACT intervention focuses on psychological flexibility through core processes such as being present, opening up, and doing what matters, and includes workbooks and mindfulness audio exercises. The control group receives usual preoperative care, including appointments with surgeons and nurse practitioners and educational workbooks about hospital orientation and lifestyle factors. Participants will be assessed on measures of anxiety, depression, psychological flexibility, well-being, cardiovascular health-related quality of life, and inflammation markers before surgery and at 8 weeks after. Researchers will monitor feasibility factors like participant satisfaction, adherence, enrollment, intervention delivery, and retention. The study aims to evaluate both the feasibility and preliminary effects of ACT during the perioperative period for CABG patients, helping guide future larger trials.