Evaluation of the Systemic Microcirculation as a Surrogate for Coronary Microcirculation in Women With ANOCA (NOCAWT)

May 2, 2026 updated by: Eduardo Tibirica, MD, PhD, National Institute of Cardiology, Laranjeiras, Brazil

Evaluation of the Systemic Microcirculation as a Surrogate for Coronary Microcirculation in Women With ANOCA: Insights Into Pathophysiology and Diagnosis Using Noninvasive, Innovative Techniques (NOCAWT)

The primary objective of this project is to validate a multi-modal systemic microvascular phenotyping platform-combining Laser Speckle Contrast Imaging (LSCI) and Sublingual Handheld Videomicroscopy (IDF imaging)-as a non-invasive surrogate for coronary microvascular function in women with ANOCA (Angina with Non-Obstructive Coronary Arteries). We aim to demonstrate that systemic microvascular signatures (microvascular reactivity and density) can predict coronary endotypes with high accuracy, potentially reducing the need for invasive diagnostics.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The study will involve women aged 18 to 65 years, with stable anginal chest pain and no coronary artery disease (ANOCA) (absence of coronary plaque in coronary angiography or computed tomography coronary angiography - CCTA), recruited at the National Institute of Cardiology (INC). The upper age limit was established to limit the influence of vascular senescence on the results.

Study Type

Observational

Enrollment (Estimated)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Eduardo Tibirica, MD, PhD
  • Phone Number: +55-21-99914-6075
  • Email: etibi@uol.com.br

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Probability Sample

Study Population

Patients from a terciary cardiology hospital.

Description

Inclusion Criteria:

  • Age 18-65 years
  • Anginal chest pain

Exclusion Criteria:

  • Malignant neoplasms
  • Autoimmune diseases
  • Acute systemic diseases
  • Pregnancy or lactation
  • Iodine allergy
  • CAD on invasive coronary angiography or coronary computed tomography angiography (CCTA)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
ANOCA
Symptomatic Group (ANOCA): n = 40 patients with stable angina and non-obstructive coronary arteries.
Procedure: Investigation of Systemic Endothelial Microvascular Function
Investigation of Systemic Endothelial Microvascular Function
Other Names:
  • Myocardial Perfusion Imaging
  • Sublingual videomicroscopy
  • Invasive coronary flow determination
  • Cutaneous Laser Speckle Contrast Imaging
CONTROL
Control Group: n = 20 age-matched women without chest pain and without CAD.
Procedure: Investigation of Systemic Endothelial Microvascular Function
Investigation of Systemic Endothelial Microvascular Function
Other Names:
  • Myocardial Perfusion Imaging
  • Sublingual videomicroscopy
  • Invasive coronary flow determination
  • Cutaneous Laser Speckle Contrast Imaging

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluation of endothelium-dependent skin microvascular reactivity.
Time Frame: Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of systemic microvascular reactivity induced by endothelium-dependent agent (acetylcholine). Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance.
Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluation of endothelium-independent skin microvascular reactivity.
Time Frame: Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of systemic microvascular reactivity induced by endothelium-independent agent (sodium nitroprusside). Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance.
Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of endothelium-dependent skin microvascular reactivity.
Time Frame: Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of systemic microvascular reactivity induced by postocclusive reactive hyperemia. Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance.
Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of sublingual microcirculation.
Time Frame: Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Sublingual microcirculatory density and perfusion will be assessed using a handheld camera based on incident dark-field (IDF) imaging.
Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Institute of Cardiology, Laranjeiras, Brazil

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

December 1, 2029

Study Completion (Estimated)

December 1, 2029

Study Registration Dates

First Submitted

April 22, 2026

First Submitted That Met QC Criteria

April 22, 2026

First Posted (Actual)

April 30, 2026

Study Record Updates

Last Update Posted (Actual)

May 5, 2026

Last Update Submitted That Met QC Criteria

May 2, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NOCoronaryArtery Women Testing

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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