How exercise affects the heart’s small blood vessels in microvascular angina

Coronary and systemic vascular responses to exercise and vasodilators in patients with angina due to microvascular dysfunction

Divaka Perera (lead researcher)

King's College London

Start date: 05 October 2016 (Duration 3 years)

Supervised by Dr Divaka Perera, this Clinical Research Training Fellow wants to understand more about microvascular disease, when the small blood vessels in the heart’s circulation don’t work properly. Around a third of people with angina do not have a visible narrowing in their heart arteries when they have an angiogram. Instead they have microvascular disease, or MVD, which causes debilitating symptoms, often on exertion. These patients have a similar prognosis to those whose arteries are narrowed and there are currently no effective treatments for MVD. MVD is diagnosed when people cannot increase blood flow in the heart’s circulation when given a drug to dilate their blood vessels. Dr Perera’s team has developed diagnostic techniques that better reflect MVD by examining blood flow changes in the heart’s circulation when people are exercising – the usual trigger for microvascular angina. Their initial results suggest that people with MVD do not increase blood flow to the heart during exercise in the normal way. In this project, the fellow will study blood flow patterns during exercise (cycling) in people with MVD and healthy volunteers. The team will work out if non-invasive techniques (magnetic resonance scanning and forearm blood flow measurements) can diagnose, monitor and be used to study MVD, and will work out why patients respond poorly to exercise. This research will give us a better understanding of MVD and may reveal new targets for treatments. Together with new techniques to diagnose the condition, this work could help to improve outcomes for people with MVD.

Project details

Grant amount £205,613
Grant type Fellowship
Application type Clinical Research Training Fellowship
Start Date 05 October 2016
Duration 3 years
Reference FS/16/49/32320
Status In progress

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