Feasibility of a novel approach to sensory mapping in angina pectoris
Research type
Research Study
Full title
Feasibility of a novel approach to sensory testing with image processing in patients with angina pectoris
IRAS ID
146589
Contact name
Rajiv Malhotra
Contact email
Sponsor organisation
Royal Liverpool and Broadgreen University Hospital Trust
Research summary
There is no unifying theory that explains typical angina pain in patients with coronary artery disease, although many exist [1]. There is a suggestion that patients who experience angina have an abnormal interaction at the spinal cord between nerves that supply internal organs and those that supply the skin [1]. Changes in the spinal cord as a result of this interaction have been found in other visceral pain conditions [2]. However, there has been no formal testing of the sensitivity of nerves in patients with angina. Published methodologies for measuring the area of the region of sensory change are limited at present, with the most common being the marking of the area with a pen and subsequent transfer of the area using tracing paper [3].
We will test the feasibility of a novel application of digital imaging to measure the area of altered sensation accurately in angina patients. The methodology is designed to facilitate a larger study that avoids drawing the area of altered sensation on the patient’s skin which is undignified and can provoke unnecessary discomfort.
The study will seek evidence of a relationship between the degree of sensory change, the areas of region of sensory change and the reported frequency and intensity of angina episodes. This will identify a physical sign to be sought in routine examination of patients with angina and provide insight into the pathophysiology.
1. Leach A, Fisher M. Myocardial ischaemia and cardiac pain – a mysterious relationship. British Journal of Pain February 2013 vol. 7 no. 1: 23-30
2. Woolf C. Central sensitization: Implications for the diagnosis and treatment of pain. Pain(2011): S2–S15
3. Edinger L, Schwartzman R, Ahmad A, Erwin K, Guillerma B, Alexander M. Objective sensory evaluation of the spread of complex regional pain syndrome. Pain Physician (2013); 16: 581-591
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
14/NW/1190
Date of REC Opinion
12 Sep 2014
REC opinion
Favourable Opinion