Study of Coronary Microvascular Dysfunction and Improvement of Left Heart Pumping in Patients with Heart Failure and Reduced Ejection Due to Non-Ischemic Causes

What this Trial Is About

Researchers are investigating the relationship between coronary microvascular dysfunction CMD and the improvement of left ventricular systolic function in patients diagnosed with heart failure with reduced ejection fraction HFrEF caused by non-ischemic causes. This condition involves the hearts reduced ability to pump blood effectively and is characterized by symptoms like breathlessness and exercise limitation. The study focuses on patients with an ejection fraction of 40% or less and explores how CMD, measured invasively, may predict heart muscle damage and affect recovery after standard medical treatment. The study involves patients with HFrEF without significant coronary artery disease who undergo diagnostic testing to assess CMD using coronary flow reserve CFR and the index of microcirculatory resistance IMR. These invasive assessments provide detailed information on coronary microvascular health. Participants receive guideline-directed medical treatment GDMT for heart failure, and the study evaluates how CMD relates to changes in heart function over time. Participants are followed for 12 months, during which researchers measure improvements in heart function and collect data through clinical assessments, imaging such as cardiac MRI, and hemodynamic measurements. Outcomes include the proportion of patients showing heart function improvement, correlations between CMD and various heart pressures, volumes, and biomarkers, as well as rates of hospitalization, death, and quality of life changes. The study aims to understand CMDs prognostic significance in non-ischemic HFrEF over a one-year period.

Relationship Between Coronary Microvascular Dysfunction and Improvement of Left Ventricular Systolic Function in Patients With Heart Failure With Reduced Ejection Fraction Caused by Non-ischemic Etiology