Comparison of Free-breathing 3D Quantitative Perfusion in Patients With MINOCA and MINOCA-mimics (COPE-CMR)

University of Zurich (UZH)

Status: Enrolling

Conditions: Non ST Elevation Myocardial Infarction; Myocarditis Acute; Myocardial Infarction With Non-Obstructive Coronary Artery; Spontaneous Coronary Artery Dissection; Takotsubo Cardiomyopathy

Treatments: Diagnostic Test: CMR

Study type: Interventional

Funder types: Other

Identifiers

NCT06323811

COPE CMR

Details and patient eligibility

About

This clinical study examines patients presenting with acute myocardial infarction and no significant coronary artery disease on coronary angiography (MINOCA) and patients with MINOCA-mimics with advanced CMR.

The present study aims to:

• assess the microvascular function with a novel quantitative 3D myocardial perfusion imaging approach in the acute phase and post-convalescence
• refine the role and diagnostic potential of advanced quantitative CMR imaging
• assess the potential prognostic significance of microvascular dysfunction and epicardial adipose tissue on cardiovascular outcomes

Participants will undergo advanced CMR imaging in the acute setting (within 10 days after event) and post convalescence (after 3 months).

Full description

Advanced CMR includes a novel free-breathing motion-informed locally low-rank quantitative 3D myocardial perfusion imaging. Perfusion imaging will be compared with 3D late gadolinium enhancement (LGE) imaging. A cine Dixon sequence is performed for the assessment of epicardial adipose tissue (EAT).

Enrollment: 75 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• acute presentation with signs/symptoms of acute coronary syndrome or myocarditis
• elevated cardiac biomarkers
• no signficant coronary artery disease on coronary angiogram or coronary CT

Exclusion criteria

• pacemaker/other devices or claustrophobia
• severe asthma, chronic obstructive lung or kidney disease
• acute pulmonary embolism
• arrhythmia on ECG
• moderate to severe valvular disease

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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75 participants in 5 patient groups

MINOCA

Experimental group

Description:

Patients with myocardial infarction with non-obstructive coronary artery disease (MINOCA) prospectively investigated with advanced CMR

Treatment:

Diagnostic Test: CMR

Myocarditis

Experimental group

Description:

Patients with suspected myocarditis prospectively investigated with advanced CMR

Treatment:

Diagnostic Test: CMR

Takotsubo cardiomyopathy

Experimental group

Description:

Patients with suspected Takotsubo cardiomyopathy prospectively investigated with advanced CMR

Treatment:

Diagnostic Test: CMR

Spontaneous coronary artery dissection (SCAD)

Experimental group

Description:

Patients with suspected/diagnosed spontaneous coronary artery dissection prospectively investigated with advanced CMR

Treatment:

Diagnostic Test: CMR

NSTEMI

Active Comparator group

Description:

Patients with confirmed non-ST elevation myocardial infarction on coronary angiography prospectively investigated with advanced CMR

Treatment:

Diagnostic Test: CMR