Women with non obstructive coronary artery disease: targeting progression to cardiac events with exercise.

The Women’s Ischemic Syndrome Evaluation suggest that 3–4 million women and men with signs/symptoms suggestive of myocardial ischemia have no obstructive coronary artery disease (INOCA). These individuals incur health-care costs/disabilities similar to many with obstructive coronary artery disease. Two thirds of women undergoing tests for ischemic heart disease have INOCA and a 2.5% yearly increased risk for major adverse cardiac event, non-fatal stroke and heart failure (HF) hospitalization over 5 years. However, treatment for HF in the later years is currently poor and metabolic syndrome and loss of oestrogen combine to drive inflammation and microvascular and cardiac dysfunction.

This PhD will examine (i) characteristics underpinning INOCA in women across different ages to determine whether progression to adverse cardiac events and HF can be decelerated using exercise and (ii) whether differing characteristics can be targeted more precisely with specific exercise regimes (e.g interval or resistance training) and/or dietary interventions.

The PhD student will work with cardiologists, cardiac rehabilitation services and GP surgeries to determine different phenotypes related to disease, medication use, age, micro/macrovascular/cardiac function, physical activity status, cardiorespiratory fitness, diet and blood borne markers. Echocardiography, Doppler ultrasound, blood sampling, fitness testing and exercise training will be undertaken during the PhD.