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)