Myocardial Infarction with Nonobstructive Coronary Arteries
Conditions
Brief summary
The present pilot study will investigate the prevalence of CMD in an unselected cohort of patients with the working diagnosis MINOCA and to study if the diagnostic yield can be improved by adding adenosine to the CMR investigation. Patient will be their own controls.
Interventions
DIAGNOSTIC_TESTCardiac magnetic resonance imaging to study coronary microvascular dysfunction
Myocardial perfusion mapping will be investigated after administration of adenosine
Sponsors
Region Stockholm
Karolinska Institutet
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Masking description
The investigators who will perform the evaluation of the CMR investigations will be blinded to all clinical data.
Intervention model description
Patients will be their own controls
Eligibility
Sex/Gender
ALL
Age
35 Years to 79 Years
Healthy volunteers
No
Inclusion criteria
* a suspected diagnosis of MINOCA or takotsubo syndrome with coronary angiography without diameter stenosis ≥50% * age 35-80 years * reading and writing proficiency in Swedish
Exclusion criteria
* Claustrofobia * Arrythmia and/or pacemaker (atrial fibrillation and AV-block I- III) * Asthma or severe chronic obstructive lung disease * eGFR \< 30 ml/min * spontaneous coronary artery dissection * acute pulmonary embolism * acute myocardial infarction type 2 * cardiomyopathy other than takotsubo syndrome * a previous myocardial infarction due to CAD
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic yield | Through investigation completion, usually 2 hours | To increase the diagnostic yield of CMR imaging in MINOCA as a working diagnosis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of CMD in MINOCA | Through investigation completion, usually 2 hours | To determine the proportion of patients with the working diagnosis of MINOCA who have CMD. |
| Prevalence of CMD in different final MINOCA diagnoses | Through investigation completion, usually 2 hours | To study the proportions of CMD in patients with a CMR imaging diagnosis of myocardial infarction, Takotsubo, respectively myocarditis and compare them with the results from a healthy control group |
| Angina pectoris | 3 Months | To investigate the occurrence of angina pectoris before inclusion and after 3 months and relate it to CMD |
Countries
Sweden
Contacts
Primary ContactPer Tornvall, MD
Backup ContactPeder Sörensson, MD
Outcome results
None listed