Project Title

The Natural History of Coronary Microvascular Dysfunction: A 10-year Follow Up of iPower

Background

CMD affects the small blood vessels of the heart and leads to reduced blood flow. It’s a common but often overlooked cause of chest pain, especially in women whose heart vessels show no blockages. Ten years ago, the iPower study examined 1,853 women and linked CMD to ongoing chest pain and reduced quality of life, but we still know little about how it develops or affects the rest of the body over time.

Aim

The aim of this study is to explore how CMD has progressed over 10 years and whether it’s associated with heart failure with preserved ejection fraction, inflammation, and broader effects on the body, particularly reduced blood flow in the brain and impaired kidney function.

Methods

The study uses a prospective, longitudinal design with 3 parts: 1) Registry-based follow-up of the original iPower cohort using national registries; 2) Surveys evaluating ongoing angina symptoms and quality of life in the original iPower cohort; 3) Clinical reassessment of 200 women, including repeat non-invasive blood flow measurements, cardiac CT, blood and urine testing. A smaller group of 60 women will also undergo advanced imaging of the heart, brain and blood vessels.