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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ANOCA | Symptomatic Group (ANOCA): n = 40 patients with stable angina and non-obstructive coronary arteries. |
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| CONTROL | Control Group: n = 20 age-matched women without chest pain and without CAD. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Investigation of Systemic Endothelial Microvascular Function | Procedure | Investigation of Systemic Endothelial Microvascular Function |
|
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of endothelium-dependent skin microvascular reactivity. | 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. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of endothelium-independent skin microvascular reactivity. | 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. |
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Inclusion Criteria:
Exclusion Criteria:
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Women presenting with stable anginal chest pain and no coronary artery disease (ANOCA) (absence of coronary plaque in coronary angiography or computed tomography coronary angiography).
Patients from a terciary cardiology hospital.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eduardo Tibirica, MD, PhD | Contact | +55-21-99914-6075 | etibi@uol.com.br |
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| ID | Term |
|---|---|
| D017566 | Microvascular Angina |
| ID | Term |
|---|---|
| D000787 | Angina Pectoris |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. |
| Evaluation of endothelium-dependent skin microvascular reactivity. | 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. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. |
| Evaluation of sublingual microcirculation. | Sublingual microcirculatory density and perfusion will be assessed using a handheld camera based on incident dark-field (IDF) imaging. | Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room. |
| D014652 |
| Vascular Diseases |