Matching in vivo to ex vivo human coronary microvascular function

Understanding the microvascular mechanisms underlying ischaemic heart disease (IHD) is currently limited by lack of image resolution in vivo, and lack of suitable ventricular biopsies ex vivo. In this first of kind project we will use our Oxford-based advanced clinical and basic science expertise to pair patient history, in vivo measures of microvascular resistance, blood biomarkers, and ex vivo microvascular structure, signaling and function to unravel processes resulting in IHD. This pilot study will recruit 20 patients with 2 main goals. First to assess whether intra-patient measures of ex vivo ventricular and atrial microvascular reactivity are comparable.  Second we will assess whether intra-patient comparisons of in vivo measures of coronary flow reserve and index of microvascular resistance are directly correlated to ex vivo measures of microvascular reactivity. Our study will form the basis for future work aimed at establishing targets for treating patients with IHD, focusing on the microcirculation.