NCT04818918

Brief Summary

Evaluation of fractional flow reserve (FFR) is a key method for assessing ischemia with a view to guiding revascularization strategy following acute coronary syndrome. A stenosis that appears to be severe by angiography may cause limited ischemia (with an FFR value \>0.80) due to the incapacity of the necrotic zone to achieve physiological hyperemia, i.e. maximal coronary flow. Recently, it has been demonstrated that absolute coronary flow, and micro- and macrovascular resistance, as measured by a thermodilution technique, using the Rayflow microcatheter (Hexacath) are strongly associated with myocardial mass. In extensive necrosis, there is a loss of myocardial mass, and these tools could be of potential interest in measuring myocardial viability, which reflects the extent of remaining viable myocardial mass. Therefore, this study aims to investigate the relationship between both absolute coronary flow and microvascular resistance, and myocardial viability assessed by MRI. In a prospective, single-centre, interventional study, we will compare absolute coronary flow and microvascular resistance in the left anterior descending artery, in patients with and without a history of ST segment elevation MI.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
45

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started May 2021

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 24, 2021

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 26, 2021

Completed
2 months until next milestone

Study Start

First participant enrolled

May 19, 2021

Completed
3.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 20, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 20, 2024

Completed
Last Updated

February 1, 2024

Status Verified

January 1, 2024

Enrollment Period

3.3 years

First QC Date

March 24, 2021

Last Update Submit

January 31, 2024

Conditions

Keywords

microvascular resistancefractional flow reservemyocardial viability

Outcome Measures

Primary Outcomes (1)

  • Coronary flow (mL/min) in the LAD

    Measurement of coronary flow in mL/min in the left anterior descending artery

    At the end of the angiography procedure

Secondary Outcomes (2)

  • Microvascular resistance

    At the end of the angiography procedure

  • Myocardial necrosis

    Cardiac MRI to be performed 7 to 30 days after index angiography procedure

Study Arms (2)

STEMI group

Patients with anterior ST segment MI treated with percutaneous coronary intervention of the left anterior descending artery, at least 7 days prior to inclusion, and scheduled for new angiography to evaluate FFR of a lesion other than the infarct-related artery. Absolute coronary flow and microvascular resistance will be measured in the LAD.

Device: Absolute coronary flow measurementDevice: Microvascular resistance measurementOther: Cardiac MRI

Control group

Patients undergoing non-urgent coronary angiography for stable angina or silent ischemia, with measure of FFR on one or more vessels (intermediate lesions \<90% without proven ischemia). Absence of any signfiicant lesion on the left anterior descending artery (as evaluated by angiography or FFR value \>0.8). Absolute coronary flow and microvascular resistance will be measured in the LAD.

Device: Absolute coronary flow measurementDevice: Microvascular resistance measurement

Interventions

Absolute coronary flow will be measured.

Control groupSTEMI group

Microvascular resistance will be measured.

Control groupSTEMI group

Cardiac MRI will be performed to evaluate myocardial viability.

STEMI group

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

Patients with recent (\>=7 days) ST segment elevation MI for the intervention group, and patients with stable angina or silent ischemia for the control group.

You may qualify if:

  • ST segment elevation MI ≥7 days treated by angioplasty of the left anterior descending (LAD) artery
  • Scheduled to undergo angiography for fractional flow reserve (FFR) assessment of a lesion other than the infarct-related artery.
  • patients undergoing non-urgent coronary angiography for stable angina or silent ischemia
  • with measure of the FFR on one or more vessels (intermediate lesion \<90% without proven ischemia)
  • absence of any significant lesion on the LAD (as assessed by angiography or FFR\>0.8)
  • Written informed consent
  • Affiliation to a social security regimen (or beneficiary thereof).

You may not qualify if:

  • Target vessel (LAD) not permeable.
  • FFR \<0.8 in the LAD
  • Coronary spasm
  • Left ventricular ejection fraction \<0.50 or a history of anterior MI in patients in the control group
  • Hypertrophic cardiomyopathy
  • Severe valvular heart disease
  • History of coronary artery bypass graft
  • Patients with limited legal capacity or patients under guardianship/tutorship
  • Patients with anticipated poor compliance as assessed by the investigator
  • Patients not affiliated to any social security regime.
  • Pregnant women.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

CHU Besancon

Besançon, 25000, France

RECRUITING

Related Publications (1)

  • Guillon B, Besutti M, Revel L, Seronde MF, Meneveau N, Chopard R. Absolute Coronary Flow Reduction Mediated by Microvascular Resistance in Myocardial Infarction: The FLOVITA Study. Catheter Cardiovasc Interv. 2025 Dec;106(7):3588-3596. doi: 10.1002/ccd.70268. Epub 2025 Oct 13.

MeSH Terms

Conditions

Myocardial InfarctionMyocardial Ischemia

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosis

Study Officials

  • Nicolas Meneveau, MD, PhD

    Centre Hospitalier Universitaire de Besancon

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 24, 2021

First Posted

March 26, 2021

Study Start

May 19, 2021

Primary Completion

August 20, 2024

Study Completion

August 20, 2024

Last Updated

February 1, 2024

Record last verified: 2024-01

Locations