Microvascular dysfunction, particularly endothelial dysfunction, is increasingly recognized as a key mechanism underlying various cardiovascular diseases (CVD), including heart failure, ischemic heart disease, atherosclerosis, stroke, dementia, and kidney failure. Chronic low-grade inflammation linked to metabolic syndrome may further drive systemic microvascular impairment. Early detection of these subclinical processes using non-invasive assessments could facilitate timely interventions to prevent disease progression. SCAPIS 2 Spectrum is a prospective observational sub-study of the Swedish Cardiopulmonary Bioimage Study (SCAPIS-2), recruiting approximately 900 subjects aged 60-75 years. The study is organized into five arms-obstructive coronary artery disease (O-CAD), angina with nonobstructive coronary arteries (ANOCA), metabolic syndrome with diabetes, left ventricular systolic dysfunction, and left ventricular diastolic dysfunction-each defined by specific inclusion and exclusion criteria. Participants will undergo a comprehensive microvascular assessment using investigational devices (including Perimed Periflux EPOS, PeriCam MultiFlow, and TCI P4) alongside stress cardiac magnetic resonance imaging (stress-CMR) for cardiac-specific evaluation.
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Correlation between device-derived skin microcirculation variables and CCTA severity metrics including CAD-RADS (0-5) and plaque burden
Timeframe: Baseline
Discriminative performance of device-derived microcirculatory variables for significant coronary stenosis
Timeframe: Baseline
Proportion of ANOCA participants (CAD-RADS <3 with angina per Rose questionnaire) who meet CMD criteria on stress-cardiac MRI using perfusion assessment
Timeframe: Baseline
Proportion of INOCA participants (CAD-RADS <3 with ishemia per Rose questionnaire) who meet CMD criteria on stress-cardiac MRI using perfusion assessment.
Timeframe: Baseline and at stress cardiac MRI- visit within 3 months
Proportion of ANOCA participants who have INOCA
Timeframe: Baseline and at stress cardiac MRI- visit within 3 months
Assess whether peripheral microvascular function reflects myocardial perfusion abnormalities in CMD and mild CAD
Timeframe: Baseline and at stress cardiac MRI- visit within 3 months
Correlation between investigational device variables and presence of Coronary Microvascular Dysfunction (CMD).
Mattias Windå, Chief Science and Innovation Officer
Timeframe: Baseline and at stress cardiac MRI- visit within 3 months
Correlation of skin microcirculation variables with echocardiographic marker for diastolic function
Timeframe: Baseline
Association of skin microcirculation variables with elevated echocardiographic marker for diastolic dysfunction.
Timeframe: Baseline
Correlation of skin microcirculation variables with biomarker for cardiac stress
Timeframe: Baseline
Association of skin microcirculation variables with elevated biomarker for measuring cardiac stress
Timeframe: Baseline
Identification of device variable thresholds predicting diastolic dysfunction/heart failure
Timeframe: Baseline and at stress cardiac MRI- visit within 3 months
Correlation of skin microcirculation variables with high levels of a biomarker for average blood glucose
Timeframe: Baseline
Correlation of device-derived microcirculation variables with nephropathy
Timeframe: Baseline
Correlation betweed device-derived microcirculatory variables with endothelial/glycocalyx/inflammation biomarkers
Timeframe: Baseline