Ultrasound-Targeted Microbubble Cavitation-Induced Nitric Oxide Production to Treat Coronary Microvascular Dysfunction

Grant Application

Primary Investigator: John J. Pacella, MD, MS

Proposed Innovation

Coronary microvascular dysfunction (CMD) is a type of nonobstructive coronary artery disease that causes the small blood vessels feeding the heart muscle to not function properly. It can lead to symptoms like chest pain (angina), fatigue, and shortness of breath. CMD remains underdiagnosed and undertreated, largely due to the lack of targeted therapies and standard diagnostics. Current management focuses primarily on symptoms.

This study will explore the use of ultrasound technology to relieve recurrent chest pain in patients with CMD. PET imaging will be used to assess the effectiveness of using ultrasound-targeted microbubble cavitation (UTMC) to increase production of nitric oxide and improve myocardial blood flow.

Improvements in Action

Nitric oxide plays a crucial role in vascular health, acting as vasodilator to relax blood vessels, reduce inflammation, and increase blood flow. This project will evaluate the effectiveness of this novel UTMC therapy — which directly targets nitric oxide production and endothelial function — in improving myocardial perfusion and clinical outcomes in CMD patients.

The study will involve 60 patients with CMD. Half will receive UTMC therapy while the other half will receive a placebo (a saline infusion with a sham ultrasound). PET imaging will be performed at baseline and 4 weeks post-treatment to assess microvascular function.

Intended Outcomes

This study has the potential to introduce a paradigm shift in CMD treatment, offering a novel, noninvasive approach that will improve patient outcomes and quality of life.