Understanding of Chest Pain in Microvascular Disease Proved by Cardiac Magnetic Resonance Image
Status:
Unknown status
Trial end date:
2014-12-01
Target enrollment:
Participant gender:
Summary
Current therapeutic options for a well-recognized group of patients with anginal symptoms-a
positive exercise tolerance testing, SPECT or perfusion defect in MRI but angiographically
normal coronary arteries-are limited. The condition, referred to as microvascular angina
(MVA) or cardiac syndrome X, is not as benign as originally reported-patients presenting with
unstable angina and nonobstructive atherosclerotic coronary artery disease have a 2% risk of
death or myocardial infarction at 30 days of follow-up. It is more common in women in whom
the first presentation of angina occurs either perimenopausally or postmenopausally. Aberrant
flow-mediated coronary vasomotion is pivotal in the pathogenesis (systemic) impairment in
endothelial function. Indeed, some centers use systemic assessments of vascular function in
their diagnostic pathways for this group of women. It was recently suggested that endothelial
dysfunction may lead to myocardial ischemia.
In the present study, the investigators tested the hypothesis that udenafil offers dual
benefits of improving vascular function and lessening ischemia in women with angina,
perfusion defect in cardiac MRI, and normal coronary arteries.