Development and Validation of a Non-invasive Algorithm for Diagnosis of Microvascular Angina Among Patients With Ischemia and Non-obstructive Coronary Artery Disease (IMAGING-CMD Study)

What this Trial Is About

Angina, a common symptom of ischemic heart disease, affects millions worldwide, including up to 11 million people in the United States. Many patients undergoing tests for angina do not show blockage in their coronary arteries, a condition known as ischemia with no obstructive coronary artery disease (INOCA). This condition leads to more repeat procedures, hospital visits, worse quality of life, and increased future heart problems. The study aims to develop and confirm a non-invasive method to diagnose and manage microvascular angina in INOCA patients using cardiac PET myocardial perfusion imaging (MPI). Participants will undergo several tests including Rb-82 rest-stress PET with blood flow measurement, exercise treadmill testing if able, and possibly coronary CT angiography if not recently done. A smaller group with abnormal PET results will have an invasive angiography procedure to validate the PET findings. The study provides recommendations for treating microvascular dysfunction based on PET results, including medications like aspirin, statins, ACE-inhibitors, beta-blockers, calcium channel blockers, and ranolazine. Patient symptoms and healthcare usage will be tracked over three months. Throughout the study, patient risk factors, symptoms, medications, and health status will be recorded. Questionnaires assessing angina symptoms, breathlessness, and quality of life will be completed at three months. Researchers will also monitor emergency room visits for chest pain and use of other diagnostic procedures. Invasive physiology data and treatment recommendations will be shared with treating doctors after three months. The overall study duration is estimated to be two years, with about 70 participants enrolled.

Imaging Coronary Microvascular Dysfunction (CMD) Study