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Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study

INTRODUCTION: Angina with no obstructive coronary artery disease (ANOCA) is a common syndrome with unmet clinical needs. Microvascular and vasospastic angina are relevant but may not be diagnosed without measuring coronary vascular function. The relationship between cardiovascular magnetic resonance...

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Autores principales: Corcoran, David, Ford, Thomas J, Hsu, Li-Yueh, Chiribiri, Amedeo, Orchard, Vanessa, Mangion, Kenneth, McEntegart, Margaret, Rocchiccioli, Paul, Watkins, Stuart, Good, Richard, Brooksbank, Katriona, Padmanabhan, Sandosh, Sattar, Naveed, McConnachie, Alex, Oldroyd, Keith G, Touyz, Rhian M, Arai, Andrew, Berry, Colin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326326/
https://www.ncbi.nlm.nih.gov/pubmed/30687508
http://dx.doi.org/10.1136/openhrt-2018-000924
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author Corcoran, David
Ford, Thomas J
Hsu, Li-Yueh
Chiribiri, Amedeo
Orchard, Vanessa
Mangion, Kenneth
McEntegart, Margaret
Rocchiccioli, Paul
Watkins, Stuart
Good, Richard
Brooksbank, Katriona
Padmanabhan, Sandosh
Sattar, Naveed
McConnachie, Alex
Oldroyd, Keith G
Touyz, Rhian M
Arai, Andrew
Berry, Colin
author_facet Corcoran, David
Ford, Thomas J
Hsu, Li-Yueh
Chiribiri, Amedeo
Orchard, Vanessa
Mangion, Kenneth
McEntegart, Margaret
Rocchiccioli, Paul
Watkins, Stuart
Good, Richard
Brooksbank, Katriona
Padmanabhan, Sandosh
Sattar, Naveed
McConnachie, Alex
Oldroyd, Keith G
Touyz, Rhian M
Arai, Andrew
Berry, Colin
author_sort Corcoran, David
collection PubMed
description INTRODUCTION: Angina with no obstructive coronary artery disease (ANOCA) is a common syndrome with unmet clinical needs. Microvascular and vasospastic angina are relevant but may not be diagnosed without measuring coronary vascular function. The relationship between cardiovascular magnetic resonance (CMR)-derived myocardial blood flow (MBF) and reference invasive coronary function tests is uncertain. We hypothesise that multiparametric CMR assessment will be clinically useful in the ANOCA diagnostic pathway. METHODS/ANALYSIS: The Stratified Medical Therapy Using Invasive Coronary Function Testing In Angina (CorMicA) trial is a prospective, blinded, randomised, sham-controlled study comparing two management approaches in patients with ANOCA. We aim to recruit consecutive patients with stable angina undergoing elective invasive coronary angiography. Eligible patients with ANOCA (n=150) will be randomised to invasive coronary artery function-guided diagnosis and treatment (intervention group) or not (control group). Based on these test results, patients will be stratified into disease endotypes: microvascular angina, vasospastic angina, mixed microvascular/vasospastic angina, obstructive epicardial coronary artery disease and non-cardiac chest pain. After randomisation in CorMicA, subjects will be invited to participate in the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) substudy. Patients will undergo multiparametric CMR and have assessments of MBF (using a novel pixel-wise fully quantitative method), left ventricular function and mass, and tissue characterisation (T1 mapping and late gadolinium enhancement imaging). Abnormalities of myocardial perfusion and associations between MBF and invasive coronary artery function tests will be assessed. The CorCMR substudy represents the largest cohort of ANOCA patients with paired multiparametric CMR and comprehensive invasive coronary vascular function tests. ETHICS/DISSEMINATION: The CorMicA trial and CorCMR substudy have UK REC approval (ref.16/WS/0192). TRIAL REGISTRATION NUMBER: NCT03193294.
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spelling pubmed-63263262019-01-25 Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study Corcoran, David Ford, Thomas J Hsu, Li-Yueh Chiribiri, Amedeo Orchard, Vanessa Mangion, Kenneth McEntegart, Margaret Rocchiccioli, Paul Watkins, Stuart Good, Richard Brooksbank, Katriona Padmanabhan, Sandosh Sattar, Naveed McConnachie, Alex Oldroyd, Keith G Touyz, Rhian M Arai, Andrew Berry, Colin Open Heart Protocol INTRODUCTION: Angina with no obstructive coronary artery disease (ANOCA) is a common syndrome with unmet clinical needs. Microvascular and vasospastic angina are relevant but may not be diagnosed without measuring coronary vascular function. The relationship between cardiovascular magnetic resonance (CMR)-derived myocardial blood flow (MBF) and reference invasive coronary function tests is uncertain. We hypothesise that multiparametric CMR assessment will be clinically useful in the ANOCA diagnostic pathway. METHODS/ANALYSIS: The Stratified Medical Therapy Using Invasive Coronary Function Testing In Angina (CorMicA) trial is a prospective, blinded, randomised, sham-controlled study comparing two management approaches in patients with ANOCA. We aim to recruit consecutive patients with stable angina undergoing elective invasive coronary angiography. Eligible patients with ANOCA (n=150) will be randomised to invasive coronary artery function-guided diagnosis and treatment (intervention group) or not (control group). Based on these test results, patients will be stratified into disease endotypes: microvascular angina, vasospastic angina, mixed microvascular/vasospastic angina, obstructive epicardial coronary artery disease and non-cardiac chest pain. After randomisation in CorMicA, subjects will be invited to participate in the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) substudy. Patients will undergo multiparametric CMR and have assessments of MBF (using a novel pixel-wise fully quantitative method), left ventricular function and mass, and tissue characterisation (T1 mapping and late gadolinium enhancement imaging). Abnormalities of myocardial perfusion and associations between MBF and invasive coronary artery function tests will be assessed. The CorCMR substudy represents the largest cohort of ANOCA patients with paired multiparametric CMR and comprehensive invasive coronary vascular function tests. ETHICS/DISSEMINATION: The CorMicA trial and CorCMR substudy have UK REC approval (ref.16/WS/0192). TRIAL REGISTRATION NUMBER: NCT03193294. BMJ Publishing Group 2018-12-30 /pmc/articles/PMC6326326/ /pubmed/30687508 http://dx.doi.org/10.1136/openhrt-2018-000924 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: http://creativecommons.org/licenses/by/4.0
spellingShingle Protocol
Corcoran, David
Ford, Thomas J
Hsu, Li-Yueh
Chiribiri, Amedeo
Orchard, Vanessa
Mangion, Kenneth
McEntegart, Margaret
Rocchiccioli, Paul
Watkins, Stuart
Good, Richard
Brooksbank, Katriona
Padmanabhan, Sandosh
Sattar, Naveed
McConnachie, Alex
Oldroyd, Keith G
Touyz, Rhian M
Arai, Andrew
Berry, Colin
Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title_full Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title_fullStr Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title_full_unstemmed Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title_short Rationale and design of the Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) diagnostic study: the CorMicA CMR sub-study
title_sort rationale and design of the coronary microvascular angina cardiac magnetic resonance imaging (corcmr) diagnostic study: the cormica cmr sub-study
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326326/
https://www.ncbi.nlm.nih.gov/pubmed/30687508
http://dx.doi.org/10.1136/openhrt-2018-000924
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