September 30, 2021Open Access
Reduced Microvascular Blood Volume as a Driver of Coronary Microvascular Disease in Patients With Non-obstructive Coronary Artery Disease: Rationale and Design of the MICORDIS Study
Structured PICO
Is microvascular blood volume reduced in INOCA patients compared to matched healthy controls?
P
Population
INOCA patients and matched healthy controls
I
Intervention
Myocardial contrast echocardiography (MCE) to determine microvascular blood volume (MBV) at baseline, during hyperinsulinemia and during stress, along with coronary function testing and cardiac magnetic resonance (CMR)
C
Comparator
Matched healthy controls
O
Outcome
Microvascular blood volume (MBV)surrogate
The MICORDIS study is designed to investigate whether reduced microvascular blood volume drives coronary microvascular disease in INOCA patients.
Abstract
The MICORDIS-study is a single-center observational cross-sectional cohort study (identifier NTR7515). The primary outcome is MBV, compared between INOCA patients and matched healthy controls. The patient group will undergo coronary function testing using a Doppler guidewire, intracoronary adenosine and acetylcholine to measure CFR and coronary vasospasm. Both the patient- and the control group will undergo myocardial contrast echocardiography (MCE) to determine MBV at baseline, during hyperinsulinemia and during stress. Subsequently, cardiac magnetic resonance (CMR) will be evaluated as a new and noninvasive diagnostic tool for CMD in INOCA patients. Microvascular endothelial function is a determinant of MBV and will be evaluated by non-invasive microvascular function testing using EndoPAT and by measuring NO production in circulating endothelial cells (ECFCs).