Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain
Introduction Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascula...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e088372.full |
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| author | Colin Berry Alex McConnachie Peter Kellman Terry Quinn Paul Donnelly Vanessa Orchard Robert A Sykes Gemma McKinley Conor Patrick Bradley Jodi Watt Natasha Fullerton |
| author_facet | Colin Berry Alex McConnachie Peter Kellman Terry Quinn Paul Donnelly Vanessa Orchard Robert A Sykes Gemma McKinley Conor Patrick Bradley Jodi Watt Natasha Fullerton |
| author_sort | Colin Berry |
| collection | DOAJ |
| description | Introduction Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality. The vascular anatomy of the heart and brain is similar with conduit arteries distributed over the surface of these organs which in turn branch into a network of microscopic penetrating arteries which provide organ perfusion via an end-organ microcirculation. It has also been demonstrated that coronary microvascular dysfunction and CSVD share common vascular risk factors and pathophysiological mechanisms of disease. This has led to a link between the conditions being hypothesised, however, there is an evidence gap clearly demonstrating this relationship. The CorCMR (coronary microvascular angina cardiovascular magnetic resonance imaging) brain imaging study will provide novel insights into the associations between small vessel disease of the heart and brain and related clinical significance.Methods and analysis The CorCMR brain imaging study is a prospective, observational, multicentre cohort study including a blinded, central analysis and independent clinical trials unit; a prespecified study nested within the CorCMR trial. We will enrol patients with anginal symptoms who have undergone invasive coronary angiography which has demonstrated no obstructive coronary artery disease. The participants will then undergo brain MRI (to detect CSVD) immediately followed by a quantitative stress perfusion cardiac MRI (to detect coronary microvascular dysfunction). Participants will also undergo neurocognitive testing. The objectives of the study are to assess the prevalence of MRI features of CSVD in patients with angina and no obstructive coronary artery disease; to assess the association between coronary microvascular dysfunction and CSVD and to assess the association between CSVD and cognition.Ethics and dissemination The CorCMR study is approved by the UK National Research Ethics Service (Reference 20/WS/0159). Findings will be disseminated through peer-reviewed publications. All patients provided written informed consent.Trial registration number ClinicalTrials.gov ID NCT04805814. |
| format | Article |
| id | doaj-art-0f2a942cc2b747fba2d90858159be932 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-0f2a942cc2b747fba2d90858159be9322025-01-14T08:00:09ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-088372Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brainColin Berry0Alex McConnachie1Peter Kellman2Terry Quinn3Paul Donnelly4Vanessa Orchard5Robert A Sykes6Gemma McKinley7Conor Patrick Bradley8Jodi Watt9Natasha Fullerton10Cardiology, Golden Jubilee National Hospital, Clydebank, UK6 Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK8 National Heart Lung and Blood Institute, Bethesda, Maryland, USA9 Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK6 Queen Elizabeth University Hospital, Glasgow, UK2 Golden Jubilee National Hospital, West of Scotland Regional Heart and Lung Centre, Glasgow, UK3 School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK5 Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK1 British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK7 University of Glasgow, Glasgow, UK6 Queen Elizabeth University Hospital, Glasgow, UKIntroduction Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality. The vascular anatomy of the heart and brain is similar with conduit arteries distributed over the surface of these organs which in turn branch into a network of microscopic penetrating arteries which provide organ perfusion via an end-organ microcirculation. It has also been demonstrated that coronary microvascular dysfunction and CSVD share common vascular risk factors and pathophysiological mechanisms of disease. This has led to a link between the conditions being hypothesised, however, there is an evidence gap clearly demonstrating this relationship. The CorCMR (coronary microvascular angina cardiovascular magnetic resonance imaging) brain imaging study will provide novel insights into the associations between small vessel disease of the heart and brain and related clinical significance.Methods and analysis The CorCMR brain imaging study is a prospective, observational, multicentre cohort study including a blinded, central analysis and independent clinical trials unit; a prespecified study nested within the CorCMR trial. We will enrol patients with anginal symptoms who have undergone invasive coronary angiography which has demonstrated no obstructive coronary artery disease. The participants will then undergo brain MRI (to detect CSVD) immediately followed by a quantitative stress perfusion cardiac MRI (to detect coronary microvascular dysfunction). Participants will also undergo neurocognitive testing. The objectives of the study are to assess the prevalence of MRI features of CSVD in patients with angina and no obstructive coronary artery disease; to assess the association between coronary microvascular dysfunction and CSVD and to assess the association between CSVD and cognition.Ethics and dissemination The CorCMR study is approved by the UK National Research Ethics Service (Reference 20/WS/0159). Findings will be disseminated through peer-reviewed publications. All patients provided written informed consent.Trial registration number ClinicalTrials.gov ID NCT04805814.https://bmjopen.bmj.com/content/14/12/e088372.full |
| spellingShingle | Colin Berry Alex McConnachie Peter Kellman Terry Quinn Paul Donnelly Vanessa Orchard Robert A Sykes Gemma McKinley Conor Patrick Bradley Jodi Watt Natasha Fullerton Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain BMJ Open |
| title | Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain |
| title_full | Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain |
| title_fullStr | Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain |
| title_full_unstemmed | Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain |
| title_short | Heart–brain microvascular MRI study: protocol for a multicentre, observational, cohort study in the UK assessing associations between small vessel disease of the heart and brain |
| title_sort | heart brain microvascular mri study protocol for a multicentre observational cohort study in the uk assessing associations between small vessel disease of the heart and brain |
| url | https://bmjopen.bmj.com/content/14/12/e088372.full |
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