Myocardial Ischemia in Non-obstructive Coronary Artery Disease

Study Overview
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Brief Summary
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The aim of the study is to assess presence of myocardial ischemia by contrast stress echocardiography in patients with symptomatic non-obstructive coronary artery disease (CAD) by CT-coronary angiography, and the clinical, vascular, biochemical and genetic markers of myocardial ischemia in such patients.

Detailed Description
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Non-obstructive coronary artery disease (CAD) is particularly common in women and associated with reduced quality of life and increased cardiovascular morbidity and mortality. The project will recruit patients with angina pectoris and non-obstructive CAD by CT- coronary angiography for further imaging with contrast stress echocardiography for diagnosis of myocardial ischemia. Better characterization of patients with symptomatic non-obstructive CAD due to myocardial ischemia will be done by vascular assessment by tonometry, biochemical and genetic markers as well as quality of life questionnaire. This interdisciplinary project is expected to add new knowledge to the impact of multimodality cardiac imaging in improving diagnosis in patients with symptomatic non-obstructive CAD.

Official Title
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Myocardial Ischemia in Non-obstructive Coronary Artery Disease

Conditions
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Coronary Atherosclerosis, Myocardial Ischemia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >30 years Chest pain and or functional dyspnoea with a duration > 6 months Non-obstructive coronary artery disease detected by CT coronary angiography Exclusion Criteria: Significant coronary artery stenosis or normal coronary arteries by CT coronary angiography Unstable coronary artery disease Significant valvular heart disease Mechanical valve prosthesis Significant arrhythmia Severly reduced pulmonary function (GOLD 3-4) Known allergy to ultrasound contrast agents Pregnancy Inability to sign informed consent to participate Other severe disease

Ages Eligible for Study
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Minimum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Angina pectoris, non-obstructive CAD<br>Contrast stress echocardiography will be performed in patients with angina pectoris and non-obstructive CAD on CT-angiography to detect presence of myocardial ischemia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of myocardial ischemia by contrast stress echocardiography | Presence of delayed myocardial contrast enhancement during stress echocardiography | 15 minutes, during contrast stress echocardopgraphy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extent of myocardial ischemia by contrast stress echocardiography | Numbers of left ventricular segments with delayed contrast enhancement during stress echocardiography | 15 minutes, during contrast stress echocardiography | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CT coronary angiography, Contrast stress echocardiography, Arterial stiffness, Quality of life, Biochemical and genetic markers