Study of Coronary Microvascular Dysfunction and Heart Failure With Preserved Ejection Fraction in Adults

What this Trial Is About

Researchers are studying coronary microvascular dysfunction CMD and its connection to heart failure with preserved ejection fraction HFpEF, especially in women and some men with symptoms of ischemia but without blocked large coronary arteries. CMD was once thought to be an imaging error but is now recognized as a significant condition linked to poor outcomes and high healthcare costs. The study aims to understand how CMD leads to heart muscle dysfunction and HFpEF, focusing on mechanisms involving inflammation, repeated ischemic episodes, and fat accumulation in heart cells. This observational study will enroll about 220 participants, including 120 symptomatic women undergoing coronary angiography who do not have obstructive coronary artery disease, and 100 women and men hospitalized with HFpEF who have not had coronary angiography. Participants will undergo various imaging and testing procedures, including invasive coronary angiography with coronary reactivity testing, high-resolution cardiac magnetic resonance imaging CMRI, coronary magnetic resonance angiography CMRA, computed coronary tomographic angiography CCTA, and rest-stress Millar testing. Some tests involve mild physical stress maneuvers like handgrip and leg exercises. The study also includes blood biomarker analysis to explore predictors of HFpEF. During the study, participants will receive comprehensive cardiac evaluations with imaging and functional testing to assess heart function and blood vessel health. Data will be collected on cardiovascular events over up to 30 years, along with symptoms, quality of life, and chest pain persistence using questionnaires. The study collects and shares de-identified data to support future precision medicine research. Participants provide informed consent and are followed long-term to better understand CMD and HFpEF linkages and outcomes.

WISE CVD - Continuation (WISE HFpEF)