The main goal is to understand what causes reduced fitness in ANOCA and whether targeted exercise can help improve it.
This study aims to better understand why patients with Angina and No Obstructive Coronary Artery Disease (ANOCA) have poor cardiorespiratory fitness and its effect on quality of life.
Investigators also want to see if a structured high-intensity exercise program (HIIT), done with remote monitoring, can safely improve heart function, fitness, and quality of life in these patients. The Investigators will use a special exercise test called cardiopulmonary exercise testing to look for patterns that can help explain exercise limitations and quality of life in ANOCA before and after a remote high-intensity exercise program.
Age 18-85
ANOCA (Anginal symptoms of chest pain or exertional dyspnea suspected to be from myocardial ischemia Invasive or CT coronary angiogram without obstructive epicardial CAD (≥50% left main or ≥70% other epicardial stenosis or fractional flow reserve ≤0.80)
Able to use the wearable and participate in a remote exercise program
Able to participate in intermittent high-intensity training.
Systolic heart failure (LVEF <50% or NYHA class III symptoms)
Prior myocardial infarction, coronary revascularization
Inability to safely undergo cardiopulmonary exercise testing, based on investigator's judgment
Pregnancy (due to unknown effects on CPET exercise markers)
Single group
EXERCISE TRAINING WITH OR WITHOUT MEDICATION
BehavioralRemote 4 weeks of high-intensity interval exercise training on three non-consecutive days of the week.
Examine cardiorespiratory fitness (change in VO2max in mL/kg/min) with cardiopulmonary exercise testing (CPET) Phenotype.
The investigators will assess VO2max (mL/kg/min) in 25 patients with ANOCA at the exercise laboratory.
Assess Changes in cardio-respiratory fitness (CRF) (VO2max) with High-Intensity Interval Exercise Training (HIIT) in Patients with ANOCA.
The investigators will examine the feasibility of a remote exercise program using ramp exercise thresholds. Based on preliminary data, they predict that adherence to the exercise sessions will exceed 80%. After four weeks of remote exercise, the investigators will reassess cardiorespiratory fitness (VO2max in mL/kg/min) after the HIIT intervention.
Health Related Quality Of Life (HRQOL) questionnaire
The investigators will assess the health-related quality of life at baseline, alongside exercise testing, and again four weeks after the completion of the study to evaluate any changes.
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