Active not recruitingNAINTERVENTIONAL

Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) Trial

This research looks into how to best help people experiencing chest pain (angina) when their main heart arteries aren't significantly blocked. This is a common problem, and current diagnosis and treatment can vary greatly. The study uses a special heart MRI scan, called stress perfusion Cardiac Magnetic Resonance Imaging (CMR), which can spot issues in the heart's smallest blood vessels, known as microvascular dysfunction. Researchers want to see if this detailed information helps doctors provide more targeted and effective treatments. It also aims to understand if this approach improves symptoms, well-being, and overall health outcomes for patients. Essentially, it's testing if a more precise diagnosis leads to better care.

At a glance

Status

Active not recruiting

Phase

Sponsor

NHS National Waiting Times Centre Board

Enrolment target

280

Start

09 Feb 2021

Estimated completion

01 Oct 2034

Microvascular Angina Angina Pectoris Angina, Stable Non-Obstructive Coronary Atherosclerosis Small Vessel Cerebrovascular Disease Coronary Artery Disease

What is this study about?

Many people experience chest pain, often called angina, and sometimes when doctors perform an angiogram (a test to look at the heart's arteries), they don't find significant blockages. This can be frustrating because the cause of the pain is unclear, and treatment approaches can vary. This study, called CorCMR, is designed to help address this problem by looking for issues in the heart's very tiny blood vessels, which might be causing the pain.

The study uses a sophisticated MRI scan of the heart, known as stress perfusion Cardiac Magnetic Resonance Imaging (CMR). This scan can show how blood flows through the heart muscle under stress. By using this technology, researchers hope to better understand if problems with these small blood vessels are the reason for the chest pain, or if there are other underlying causes that haven't been fully explored yet.

Ultimately, this research aims to figure out if having this detailed information from the MRI scan can lead to better, more personalised treatment plans. It will compare whether patients whose doctors know these specific MRI results feel better, have a better quality of life, and experience improved long-term health, compared to those whose doctors don't have this information. This could help make sure people with this type of chest pain get the most appropriate and effective care.

Key takeaways

Investigating chronic chest pain without major artery blockages.
Uses a special heart MRI scan to look at tiny blood vessels.
Aims to see if detailed scan results lead to better treatments.
Compares different ways of using the MRI information.
Could help improve diagnosis and care for this common condition.

Who may be eligible?

To join this study, you need to be at least 18 years old and currently experiencing symptoms of chest pain or angina. You must have had an angiogram within the last three months that did not show major blockages in your heart arteries, and your doctors are planning your ongoing medical care.

However, there are certain reasons why someone might not be able to participate. You wouldn't be eligible if your angiogram showed significant blockages (more than 70% in one main artery or 50-70% in two adjacent areas of an artery larger than 2.5mm), or if you've recently had or are planned to have a procedure to open up your arteries, like a stent or bypass surgery. If you've had previous bypass surgery, you're also not eligible.

Additionally, if your doctors have already identified another clear medical reason for your chest pain, such as severe anaemia, a specific heart valve problem, or a thickened heart muscle, you wouldn't be able to join. You also can't have any medical conditions that would make the MRI scan or the medication used during the scan unsafe for you, such as very poor kidney function or severe asthma. Finally, you must be able and willing to give your agreement to take part in the study.

Quick self-check

Are you 18 years old or older?
Do you experience chest pain (angina)?
Did you have an angiogram within the last 3 months that showed no major heart artery blockages?
Are you able to have an MRI scan and any medication for it, without any known severe allergies or other conditions that would make it unsafe?
Have you *not* had heart bypass surgery in the past?
Do your doctors *not* already have another clear explanation for your chest pain (e.g., severe anaemia or specific heart valve disease)?

This is a guide only — the research team will confirm whether you can take part.

What does participation involve?

If you join this study, you will undergo a special heart MRI scan (stress perfusion CMR). After the scan, some participants' doctors will be told the detailed results of this scan, which might help guide their treatment. For other participants, the MRI scan will be performed, but the results won't be immediately shared with their doctor, as part of the study design to compare different approaches. This is a "double-blind" study, meaning neither you nor your doctor will know which group you are in to ensure fair comparison.

The study will involve follow-up appointments to monitor your symptoms, well-being, and overall health over a period of time. You will continue to receive your usual medical care throughout the study, which may be adjusted by your doctor based on what they know. The total duration of your participation in the study will involve initial assessments, the MRI scan, and subsequent follow-up visits, which will be explained in detail by the research team.

Potential risks and benefits

Taking part in this study could potentially benefit you by providing a more precise understanding of the cause of your chest pain through advanced MRI scanning. For some, this information might lead to more tailored and effective treatment plans, potentially improving symptoms and overall well-being. However, there's also the possibility that the study may not directly change your treatment or immediate health outcomes. As with any medical procedure, there are potential risks associated with the MRI scan and the medication given during it, such as allergic reactions or temporary discomfort; these will be fully explained before you agree to participate. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (3)

University Hospital Hairmyres
East Kilbride, United Kingdom
University Hospital Ayr
Ayr, United Kingdom
Golden Jubilee National Hospital
Glasgow, United Kingdom

Common questions

What is angina?

Angina is a type of chest pain or discomfort caused by reduced blood flow to the heart muscle. It's often described as a squeezing or pressure sensation.

What does 'non-obstructive coronary arteries' mean?

It means that your main heart arteries don't have significant blockages, even though you're experiencing chest pain. The problem might be in the very small blood vessels instead.

What is a heart MRI (CMR) scan?

A Cardiac Magnetic Resonance Imaging (CMR) scan uses strong magnets and radio waves to create detailed pictures of your heart, helping doctors see its structure and how well it's working without using X-rays.

Will I know my MRI results immediately?

Not necessarily. This study is designed to compare different approaches, so for some participants, the detailed MRI results will be shared with their doctor, while for others, they won't be, at least not right away. You and your doctor won't know which group you are in.

Can I leave the study at any time?

Yes, you have the right to withdraw from the study at any point without it affecting your ongoing medical care.