70 Participants Needed

Imaging Techniques for Angina

AR
LS
Overseen ByLilia Soriano, BS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Icahn School of Medicine at Mount Sinai
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Angina is a common clinical symptom of ischemic heart disease, affecting up to 11 million people in the United States alone, and 112 million people globally. Despite this, 4 in 10 patients undergoing elective coronary angiography for angina and ischemia do not have evidence of obstructive coronary artery disease (CAD). This condition of ischemia with no obstructive CAD (INOCA) is associated with high clinical and economic morbidity, as these patients have a higher rate of repeat procedures and hospitalizations, worse quality of life, future adverse cardiovascular events and frequent time missed from work. The overall objective of this study is to develop and validate a non-invasive algorithm for diagnosis and management of patients with INOCA and suspected microvascular dysfunction centered around cardiac PET MPI. A secondary goal of the study is to assess for improvement in patient symptoms, function and quality of life from PET-guided management of CMD in patients with INOCA. This study will take place at Mount Sinai Morningside in the PET and CTunit on the 3rd floor. The sub-study will occur at Mount Sinai Morningside Cath Lab on the 3rd floor. The study will enroll an estimated total of 70 subjects, 12 of which will also participate in the sub-study. The study is estimated to last 2 years.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

What data supports the effectiveness of the treatment Coronary CT angiogram, Functional Angiography, PET imaging, Positron Emission Tomography, PET scan, PET imaging, Treadmill exercise stress study for angina?

Research shows that imaging techniques like PET and CT scans are effective in diagnosing coronary artery disease (CAD) by providing detailed pictures of the heart's blood flow and structure. These methods help doctors make better decisions about managing CAD, which can lead to improved patient outcomes.12345

Is imaging for angina safe for humans?

Imaging techniques like SPECT and CT angiography have been studied for safety, showing that adverse events are generally mild and rare. For example, in one study, no serious events like heart attacks or severe complications were reported, suggesting these imaging methods are generally safe for humans.678910

How does this treatment for angina differ from other treatments?

This treatment for angina uses advanced imaging techniques like echocardiography, cardiac magnetic resonance, and computed tomography to diagnose and manage the condition. These imaging methods are non-invasive and provide detailed information about the heart's structure and function, which can help in making more accurate treatment decisions compared to traditional methods.1112131415

Research Team

KP

Krishna Patel, MBBS, MSc

Principal Investigator

Icahn School of Medicine at Mount Sinai

Eligibility Criteria

This trial is for patients with symptoms of exertional angina or shortness of breath, who have non-obstructive coronary artery disease confirmed by tests. It's not for those with severe kidney issues, certain heart conditions, pregnant women, or people unable to consent.

Inclusion Criteria

I experience chest pain or shortness of breath when I exert myself.
My heart's arteries are not severely blocked.

Exclusion Criteria

I do not have severe asthma/COPD, heart rhythm problems, or very low blood pressure.
Pregnancy
My kidney function is low, with an eGFR under 30.
See 5 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Baseline Assessment

Participants undergo Rb-82 rest-stress myocardial perfusion imaging PET with flow quantitation and an exercise treadmill test

1-2 weeks
1 visit (in-person)

Treatment

Participants receive PET-guided management recommendations for CMD, including medication adjustments

3 months
2 visits (in-person), 1 visit (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including collection of patient symptoms and health status

3 months
1 visit (in-person), 1 visit (virtual)

Treatment Details

Interventions

  • Coronary CT angiogram
  • Functional Angiography
  • PET imaging
  • Treadmill exercise stress study
Trial Overview The study aims to develop a non-invasive method using PET scans and other imaging techniques to diagnose and manage microvascular dysfunction in patients without significant coronary artery blockages.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Patients with INOCAExperimental Treatment4 Interventions
Patients to undergo coronary angiogram and/or coronary CT angiogram for suspected ischemic symptoms of angina and dyspnea but do not have obstructive epicardial coronary artery disease.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Icahn School of Medicine at Mount Sinai

Lead Sponsor

Trials
933
Recruited
579,000+

Findings from Research

Functional imaging techniques, including Single-photon-emission computed tomography (SPECT) and stress perfusion magnetic resonance imaging, are highly accurate for detecting significant coronary artery disease (CAD) and identifying patients who may benefit from coronary revascularization.
Recent advancements in cardiac computed tomography (CT) allow for myocardial perfusion assessment (CT-MPI), showing promising diagnostic accuracy similar to traditional methods, but further studies are needed to evaluate its prognostic value and address concerns about radiation exposure and contrast agent use.
CT imaging of myocardial perfusion: possibilities and perspectives.Becker, A., Becker, C.[2021]
In a 2-year study involving 1266 patients, ambulatory cardiac stress testing in primary care settings was found to be safe, with no serious adverse events like heart attacks or hospitalizations reported.
The study suggests that while this testing is safe for the general population, further research is needed to assess its appropriateness for higher-risk patients and its long-term benefits.
Ambulatory cardiac single-photon emission computed tomography at the primary care physician's office: a descriptive study.Chaptini, N., Dontaraju, VS., Concepcion, F., et al.[2010]

References

Quality-of-Life Outcomes With Anatomic Versus Functional Diagnostic Testing Strategies in Symptomatic Patients With Suspected Coronary Artery Disease: Results From the PROMISE Randomized Trial. [2023]
Nuclear cardiac stress testing in the era of molecular medicine. [2008]
The role of noninvasive imaging in coronary artery disease detection, prognosis, and clinical decision making. [2013]
CT imaging of myocardial perfusion: possibilities and perspectives. [2021]
Cardiac imaging to investigate suspected cardiac pain in the post-treadmill era. [2021]
[Comparison of myocardial perfusion imaging by thallium-201 single-photon emission computed tomography with SUNY4001 (adenosine) and exercise--crossover clinical trial at multi-center]. [2017]
The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients. [2016]
Ambulatory cardiac single-photon emission computed tomography at the primary care physician's office: a descriptive study. [2010]
[Stress cardiac MRI in management of ischemic heart disease]. [2015]
10.United Statespubmed.ncbi.nlm.nih.gov
Predicting adverse outcome with exercise SPECT technetium-99m sestamibi imaging in patients with suspected or known coronary artery disease. [2019]
11.United Statespubmed.ncbi.nlm.nih.gov
The year in coronary artery disease. [2016]
Update on cardiac imaging techniques 2014. [2016]
[The best of nuclear cardiology and MRI in 2006]. [2016]
[Non-invasive imaging for the detection of coronary artery disease]. [2016]
15.United Statespubmed.ncbi.nlm.nih.gov
The role of imaging techniques in stress testing. [2016]