Coronary Artery Disease
Conditions
Keywords
Reversible ischemia, microvascular dysfunction
Brief summary
Diagnosis of relative contributions of large artery blockages and microvascular blockages is very much needed in the treatment of coronary artery disease. In order to achieve this, two novel parameters, pressure drop coefficient (CDP), which combines flow and pressure readings and Lesion flow coefficient (LFC), which combines anatomical details of the lesion with pressure and flow readings, are being investigated.
Detailed description
Diagnosis of relative contributions of large artery blockages and microvascular blockages is very much needed in the treatment of coronary artery disease. In order to achieve this, two novel parameters, pressure drop coefficient (CDP), which combines flow and pressure readings and Lesion flow coefficient (LFC), which combines anatomical details of the lesion with pressure and flow readings, are being investigated. The diagnostic parameters will be correlated with Coronary Flow Reserve (CFR)values obtained using Positron Emission Tomography (PET) imaging. They will also be correlated with Fractional Flow Reserve (FFR).
Interventions
PROCEDURECardiac PET, Coronary catheterization
Patients would under go a Cardiac rest and stress PET scan and include the following drug administration: 1. N-13 Ammonia radionuclide - Two doses, 10 mCi for rest, 20 mCi for stress 2. Lexiscan - stress agent for PET scan Patients would also undergo Coronary catheterization including the following drug administration and device usage: 1. Combowire to obtain pressure and flow readings on Combomap machine (Volcano Therapeutics, CA). 2. Adenosine - stress agent during catheterization, 140 ug/Kg/min
Sponsors
University of Cincinnati
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* 18 years of age or above * Patients referred to a stress test by a Cardiologist * Acute Chest pain, as per patient input. * Risk Assessment with prior test results and/or previous history of known chronic stable CAD. * Borderline or discordant stress testing where obstructive CAD remains a concern. * New or worsening symptoms- Abnormal coronary angiography or abnormal prior stress imaging study. * Coronary stenosis or anatomic abnormality of uncertain significance. * In absence of reliable diagnostic information from another imaging modality.
Exclusion criteria
* Left ventricular ejection fraction less the 25% determined by gated SPECT imaging * Non-dialysis dependent chronic kidney disease with baseline serum creatinine greater than 2.5 gm/dL. * History of type II heparin-induced thrombocytopenia. * Significant co-morbid condition that is medically unstable and would make coronary angiography prohibitive or contraindicated. * Pregnant women. * Incapacitated for Consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quantification of relative contributions of large artery disease and microvascular disease | 2 years | Correlation Coronary Flow Reserve (CFR) from Positron Emission Tomography (PET)imaging with diagnostic parameters, Pressure Drop Coefficient (CDP) and Lesion Flow Coefficient (LFC). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quantification of relative contributions of large artery disease and microvascular disease | 2 years | Correlation of CDP and LFC with invasively measured Fractional Flow Reserve (FFR) values. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORRupak K Banerjee, PhD
University of Cincinnati , CVAMC
PRINCIPAL_INVESTIGATORMohamed Effat, MD
Univesity of Cincinnati, University Hospital
PRINCIPAL_INVESTIGATORImran Arif, MD
University of Cincinnati and University Hospital
PRINCIPAL_INVESTIGATORHanan Kerr, MD
University of Cincinnati
Outcome results
None listed