Microvascular dysfunction - response to exercise and vasodilators

• Research type

  Research Study

• Full title

  Coronary and systemic vascular responses to exercise and vasodilators in patients with microvascular dysfunction

• IRAS ID

  207124

• Contact name

  Divaka Perera

• Sponsor organisation

  King's College London

• Duration of Study in the UK

  2 years, 8 months, 1 days

• Research summary

  Angina (chest pain upon exertion) in the traditional sense is caused by narrowings of the coronary (blood vessel supplying the heart) arteries, limiting the amount of blood supplied to the heart during exercise. However up to forty percent of angina sufferers can have visually unobstructed heart arteries and suffer from microvascular coronary disease (MVD). This is detected by showing an inability to sufficiently increase coronary blood flow in response to chemical vasodilation. We look to understand this mechanism by studying coronary blood flow during exercise, the physiological trigger for symptoms. This method has been used by our research group to understand abnormalities in coronary blood flow during other disease states such as valve disease and pilot data would suggest that MVD patients have inefficient coronary blood flow during exercise. We also look to explore this on a chemical level to understand if the inefficiency is due to a problem with the blood vessel cell lining, muscle lining or both. Studies show that chemicals behave in a similar way in forearm and coronary arteries, we look to develop this to provide a future model to enable us to safely identify MVD sufferers. Cardiac magnetic resonance imaging (CMR) is a non-invasive scan to look at blood flow in the heart during rest and stress. Recent advances in CMR enable us to characterise the absolute blood flow gradient from the inner to outer layer of heart muscle during exercise, which has not yet been looked at in MVD patients. Overall we hope to establish the mechanism of dysfunction in MVD sufferers to innovate future treatments, alongside developing non-invasive tools to identify sufferers and monitor their response to potential therapies.

• REC name

  London - London Bridge Research Ethics Committee

• REC reference

  17/LO/0203

• Date of REC Opinion

  16 Mar 2017

• REC opinion

  Further Information Favourable Opinion