RecruitingNot ApplicableInterventional

Exploring the link between coronary microvascular dysfunction and heart failure with preserved ejection fraction

This study is exploring why some people with a type of heart failure called "heart failure with preserved ejection fraction" (HFpEF) don't respond well to current treatments. It focuses on a condition where the small blood vessels in the heart don't widen properly when needed, called coronary microvascular dysfunction (CMD). We want to understand if CMD plays a key role in HFpEF or if it's just a side effect. By comparing people with HFpEF who also have CMD to those with HFpEF only, the study hopes to find clearer answers. This could lead to better treatments for HFpEF in the future.

At a glance

Status

Recruiting

Phase

Not Applicable

Enrolment target

Start

03 Apr 2025

Estimated completion

31 Oct 2027

Coronary microvascular dysfunction (CMD) and heart failure with preserved ejection fraction (HFpEF)

What is this study about?

Imagine your heart as a pump that sends blood around your body. Sometimes, the heart can’t pump enough blood, and this is called heart failure. One type of heart failure, called 'heart failure with preserved ejection fraction' (HFpEF), means your heart muscle still squeezes normally, but it might be too stiff to fill with enough blood. People with HFpEF often feel very breathless during exercise, and unfortunately, there aren't many really effective treatments for it right now.

Researchers think that one reason for this could be a problem with the tiny blood vessels in the heart, called coronary microvascular dysfunction (CMD). These tiny vessels are supposed to open wider to give your heart more blood when it's working hard, like when you're exercising. If they don't do this properly, your heart might not get enough blood. We know that many people with HFpEF also have CMD, but we don't fully understand if CMD actually causes HFpEF or if it's just something that happens alongside it.

This study aims to get a clearer picture of the connection between HFpEF and CMD. We will look closely at people who have both conditions and compare them to people who have HFpEF but don't have CMD. By doing this, we hope to learn if CMD makes HFpEF worse or if it leads to different symptoms. This knowledge could be very important as it might help us find new and better ways to treat HFpEF in the future, providing more targeted care.

Key takeaways

The study aims to understand why some heart failure treatments aren't working for HFpEF.
It focuses on a problem with tiny heart blood vessels called CMD.
Participation involves detailed heart assessments, including specialised scans and lab tests.
You must have HFpEF and be scheduled for a coronary angiogram to participate.
Potential benefits include a very thorough heart check-up.
The study has a small, assessed radiation risk from additional checks during your angiogram.

Who may be eligible?

This study is looking for adults aged between 18 and 85 years old. To take part, you must have been diagnosed with a specific type of heart failure called heart failure with preserved ejection fraction (HFpEF).

You also need to be scheduled to have a procedure called a coronary angiogram as part of your usual medical care. This procedure helps doctors look at the blood vessels in your heart.

However, you won't be able to join if you have certain other heart problems, such as serious valve issues, significant blockages in your main heart arteries, or congenital heart disease (a heart problem you were born with). You also can't take part if you are pregnant, or if you are already involved in another specific type of clinical trial.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you between 18 and 85 years old?
Have you been diagnosed with heart failure with preserved ejection fraction (HFpEF)?
Are you scheduled to have a coronary angiogram as part of your normal care?
Do you not have severe problems with your heart valves or large artery blockages?
Are you able to do exercises like walking or cycling?
Are you not pregnant and not currently in another specific type of clinical trial?

Answer every question to see your result.

What does participation involve?

If you decide to take part, you'll be involved in a study spread over about 9 weeks. During this time, we will carefully check your heart both when you are resting and when you are exercising. This will involve some procedures in a special lab called a cardiac catheter lab, which are more detailed than usual checks. You will also have a type of scan called a cardiac MRI, which gives very detailed pictures of your heart, without using radiation. We will then compare how people with and without CMD react to exercise and common treatments for chest pain.

Potential risks and benefits

Participating in this study means you will receive a very detailed check-up of your heart, which could give you and your doctors a better understanding of your specific heart condition. This study is important for future research and could eventually help many others with HFpEF. However, there will be a little extra radiation exposure during your coronary angiogram than you'd normally have. While there's a theoretical, small risk of issues from radiation over time, experts have looked at this carefully and believe the risk is very low, similar to standard medical care. You are completely free to withdraw from the study at any time without giving a reason, and this will not affect your usual medical care.

Locations (2)

St Thomas' Hospital
Approximate
London, United Kingdom
King's College Hospital
Approximate
London, United Kingdom

Common questions

What is HFpEF?

HFpEF stands for heart failure with preserved ejection fraction. It means your heart muscle squeezes normally, but it might be too stiff to fill properly with blood. This can make you feel breathless, especially when exercising.

What is CMD?

CMD stands for coronary microvascular dysfunction. This is a problem with the tiny blood vessels in your heart that are meant to open wider to give your heart more blood when it needs it. If they don't work properly, your heart might not get enough blood.

What is Ranolazine?

Ranolazine is a medication that is sometimes used to treat chest pain (angina). In this study, we are exploring if it could have a role in treating heart conditions like those we are studying.

Will I have to take any new medication?

The study mentions Ranolazine as an intervention being looked at. This means you might be given Ranolazine as part of the study, but the study will explain this fully.

Where is the study taking place?

The study is being run from King's College London and recruitment and tests will take place at St Thomas' and King's College Hospital in the UK.

How to find out more

Becker Al-Khayatt

becker.al-khayatt@kcl.ac.uk +44 (0)2071887188 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.