Cardiovascular Diseases Clinical Trial
To determine whether an impairment of myocardial perfusion reserve is an early indicator of coronary artery disease.
BACKGROUND:
Impairment of coronary vasofunction is believed to be one of the earliest manifestations of
coronary heart disease (CHD). The impact of risk factors such as elevated cholesterol
levels, diabetes, hypertension, and smoking on the coronary microcirculation remains largely
unknown.
DESIGN NARRATIVE:
The cross-sectional study will determine whether an impairment of the myocardial perfusion
reserve provides a marker of coronary heart disease (CHD) by comparing it to other novel
measures of subclinical vascular disease, and by testing its association with risk factors
for CHD. The study is ancillary to the Multi-Ethnic Study of Atherosclerosis ("MESA"), which
is an NHLBI funded, prospective observational study of the characteristics of subclinical
cardiovascular disease, i.e. disease detected non-invasively before it has produced signs
and symptoms. In MESA new measures of subclinical disease such as coronary artery calcium
and impaired brachial artery reactivity are to be examined to investigate their
relationships to well-established risk factors and clinical events. Myocardial perfusion
reserve (MPR)is a useful measure of coronary vasofunction that should be included in an
evaluation of new measures of subclinical disease. An impaired MPR appears to be a specific
early indicator of the functional impairment of the microcirculation in patients with risk
factors for coronary artery disease. Magnetic resonance imaging (MRI) will be used as an
advanced, quantitative imaging modality to determine in short (20 minute) exams the
myocardial perfusion reserve in a group of 400 MESA participants. The study tests the
hypothesis that impaired myocardial perfusion reserve indicates the presence of subclinical
coronary atherosclerosis and coronary microvascular disease.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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