The Value of Measuring Retinal Vascular Density by Optical Coherence Tomography-Angiography (OCT-A) in Patients With Microvascular Angina Confirmed by Myocardial Microcirculatory Resistance Index (MRI).
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 158
- 试验地点
- 1
- 主要终点
- Retinal vascular density by "inner vessel length density" determined by OCT-A
研究概览
简要总结
Microvascular angina is thought to affect around 112 million patients worldwide. However, this figure is underestimated due to the difficulty of making the diagnosis. It is a pathology caused by an alteration in the microcirculation of the heart muscle, which is not detectable on a standard coronary angiogram.
In view of its prognostic, therapeutic and medico-economic value, scientific societies currently recommend invasive measurement of the microcirculatory resistance index (MRI) to diagnose microvascular angina, in the absence of significant lesions on coronary angiography.
Several research teams, including our own, have shown that cardiovascular risk is associated with alterations in the vascularization of the small vessels (microcirculation) of the retina. Unlike the study of cardiac vessels, the study of retinal microcirculation using fundus photography (OCT-A) is simple, rapid, non-invasive and inexpensive. It appears to be an interesting alternative to the measurement of IMR for the diagnosis of microvascular angina.
This hypothesis has never yet been tested. The demonstration of an association between a decrease in retinal vascular density measured by OCT-A and an alteration in coronary microvascular function measured by IMR would pave the way for a completely non-invasive diagnosis of patients.
This is an observational, cohort, prospective, single-center pilot study comparing people who have received an IMR measurement as part of INOCA.
It is planned to include 158 participants. The overall follow-up period for each patient in the research is 12 months.
In routine care, IMR is measured during coronary angiography in patients presenting with ischemia on a non-invasive test and/or stress symptoms such as angina or dyspnea, for whom coronary angiography does not reveal any significant epicardial lesion.
Following this examination, two groups will be formed: a group with an IMR<25 and a group with an IMR≥25. Clinically, the study aims to determine the potential role of retinal OCT-A as a non-invasive examination for the diagnosis and/or follow-up of INOCA.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients managed at Dijon University Hospital, having had an IMR measurement as part of INOCA during a coronary angiographic examination, consecutively includible, without angiographically or functionally significant coronary epicardial lesion (FFR < 0.80) explaining the clinical picture (= INOCA)
- •Person having given oral consent
排除标准
- •Person not affiliated or not benefiting from a social security scheme
- •Person subject to a legal protection measure (curatorship, guardianship) or a safeguard of justice measure
- •Pregnant or breast-feeding women
- •An adult incapable or unable to give consent
- •Person with macular or retinal pathology, or severe bilateral myopia
- •Person with genetic or idiopathic cardiomyopathy (dilated, hypertrophic or restrictive cardiomyopathy)
研究组 & 干预措施
IMR<25
People without microvascular angina
干预措施: Blood sampling (Biological)
IMR<25
People without microvascular angina
干预措施: Ophthalmological examination (Procedure)
IMR<25
People without microvascular angina
干预措施: angina severity questionnaire (Other)
IMR≥25
People with microvascular angina
干预措施: Blood sampling (Biological)
IMR≥25
People with microvascular angina
干预措施: Ophthalmological examination (Procedure)
IMR≥25
People with microvascular angina
干预措施: angina severity questionnaire (Other)
结局指标
主要结局
Retinal vascular density by "inner vessel length density" determined by OCT-A
时间窗: At baseline
次要结局
未报告次要终点