Effect of Beta-blockers on Coronary Flow and Resistance in Patients With ANOCA

Summary

The goal of this clinical trial is to learn whether beta-blockers can improve coronary blood flow and reduce resistance in patients with angina and no obstructive coronary arteries (ANOCA). The main questions it aims to answer are: * Do beta-blockers improve coronary blood flow in patients with ANOCA? * Do beta-blockers reduce coronary microvascular resistance in these patients? Researchers will compare a beta-blocker to a placebo to see if the medication has measurable effects on coronary circulation. Participants will: * Receive a beta-blocker or a placebo * Undergo specialized heart tests (such as coronary flow and resistance measurements) before and after treatment.

Timeline

Start

2025-07-03

Primary completion

2025-12-31

Completion

2025-12-31

Publications

• Background Erdogan D, Gullu H, Caliskan M, Ciftci O, Baycan S, Yildirir A, Muderrisoglu H. Nebivolol improves coronary flow reserve in patients with idiopathic dilated cardiomyopathy. Heart. 2007 Mar;93(3):319-24. doi: 10.1136/hrt.2006.091751. Epub 2006 Oct 25.
• Background Galderisi M, Cicala S, D'Errico A, de Divitiis O, de Simone G. Nebivolol improves coronary flow reserve in hypertensive patients without coronary heart disease. J Hypertens. 2004 Nov;22(11):2201-8. doi: 10.1097/00004872-200411000-00024.
• Background Koepfli P, Wyss CA, Namdar M, Klainguti M, von Schulthess GK, Luscher TF, Kaufmann PA. Beta-adrenergic blockade and myocardial perfusion in coronary artery disease: differential effects in stenotic versus remote myocardial segments. J Nucl Med. 2004 Oct;45(10):1626-31.
• Background Bottcher M, Czernin J, Sun K, Phelps ME, Schelbert HR. Effect of beta 1 adrenergic receptor blockade on myocardial blood flow and vasodilatory capacity. J Nucl Med. 1997 Mar;38(3):442-6.
• Background Togni M, Vigorito F, Windecker S, Abrecht L, Wenaweser P, Cook S, Billinger M, Meier B, Hess OM. Does the beta-blocker nebivolol increase coronary flow reserve? Cardiovasc Drugs Ther. 2007 Apr;21(2):99-108. doi: 10.1007/s10557-006-0494-7.
• Background Billinger M, Seiler C, Fleisch M, Eberli FR, Meier B, Hess OM. Do beta-adrenergic blocking agents increase coronary flow reserve? J Am Coll Cardiol. 2001 Dec;38(7):1866-71. doi: 10.1016/s0735-1097(01)01664-3.

Drugs

Indications