Angina, Microvascular
Conditions
Keywords
microcirculation, Laser Speckle Contrast Imaging, Sublingual videomicroscopy
Brief summary
The primary objective of this project is to validate a multi-modal systemic microvascular phenotyping platform-combining Laser Speckle Contrast Imaging (LSCI) and Sublingual Handheld Videomicroscopy (IDF imaging)-as a non-invasive surrogate for coronary microvascular function in women with ANOCA (Angina with Non-Obstructive Coronary Arteries). We aim to demonstrate that systemic microvascular signatures (microvascular reactivity and density) can predict coronary endotypes with high accuracy, potentially reducing the need for invasive diagnostics.
Detailed description
The study will involve women aged 18 to 65 years, with stable anginal chest pain and no coronary artery disease (ANOCA) (absence of coronary plaque in coronary angiography or computed tomography coronary angiography - CCTA), recruited at the National Institute of Cardiology (INC). The upper age limit was established to limit the influence of vascular senescence on the results.
Interventions
PROCEDUREInvestigation of Systemic Endothelial Microvascular Function
Investigation of Systemic Endothelial Microvascular Function
Sponsors
National Institute of Cardiology, Laranjeiras, Brazil
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 65 Years
Inclusion criteria
* Age 18-65 years * Anginal chest pain
Exclusion criteria
* Malignant neoplasms * Autoimmune diseases * Acute systemic diseases * Pregnancy or lactation * Iodine allergy * CAD on invasive coronary angiography or coronary computed tomography angiography (CCTA)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of endothelium-dependent skin microvascular reactivity. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. | Evaluation of systemic microvascular reactivity induced by endothelium-dependent agent (acetylcholine). Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of endothelium-independent skin microvascular reactivity. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. | Evaluation of systemic microvascular reactivity induced by endothelium-independent agent (sodium nitroprusside). Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance. |
| Evaluation of endothelium-dependent skin microvascular reactivity. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. | Evaluation of systemic microvascular reactivity induced by postocclusive reactive hyperemia. Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance. |
| Evaluation of sublingual microcirculation. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. | Sublingual microcirculatory density and perfusion will be assessed using a handheld camera based on incident dark-field (IDF) imaging. |
Contacts
CONTACTEduardo Tibirica, MD, PhD
Outcome results
None listed