Metabolic Intervention in the Right Ventricle in Pulmonary Arterial Hypertension
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- Right ventricular oxygen consumption divided by the rate pressure product
研究概览
简要总结
The purpose of this study is to use non-invasive imaging to determine the metabolic phenotype of the right ventricle in patients with pulmonary arterial hypertension across a spectrum of disease severity.
详细描述
Current medical therapy for pulmonary arterial hypertension (PAH) is aimed at reducing pulmonary vascular resistance (PVR) but not ameliorating right ventricular (RV) failure, the major cause of death. There are no RV-specific therapies currently available for PAH, in part because the pathophysiology of RV failure is poorly understood.
The investigators hypothesize that the RV in PAH develops a distinct metabolic pattern characterized by increased glycolysis, impaired oxidative metabolism and lipid deposition, which are associated with RV failure.
Specific Aim 1. To test the hypothesis that the RV in human PAH exhibits lipid deposition, increased glycolysis and impaired fatty acid oxidation. The investigators will measure RV oxidative metabolism and glycolysis in PAH patients and controls using positron emission tomography 11C acetate and [18F]fluoro-deoxy-D-glucose imaging and measure myocardial lipid accumulation using magnetic resonance spectroscopy imaging.
Specific Aim 2. To test the hypothesis that an abnormal RV metabolic profile is associated with RV dysfunction and reduced exercise capacity in PAH. PET and MRS findings will be correlated with RV function, patient exercise capacity and a blood metabolic profile.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Heritable or idiopathic PAH
- •18 years or older
- •Able to give informed consent
排除标准
- •Pregnancy
- •Type 1 diabetes mellitus
- •Prednisone use
- •PAH associated with any condition other than idiopathic or heritable
- •Implanted ferromagnetic material incompatible with MRI
结局指标
主要结局
Right ventricular oxygen consumption divided by the rate pressure product
时间窗: At time of C11 acetate PET scan
kmono divided by the rate pressure product (heart rate X systolic blood pressure)
次要结局
- Right ventricular oxygen consumption (kmono)(At time of C11 acetate PET scan)
- Right ventricular glucose uptake (standardized uptake value)(At time of 18-FDG PET scan)
- Correlation of kmono, kmono/RPP, FDG uptake, and myocardial triglyceride content with plasma metabolic profile(Day 1)
- Percent myocardial triglyceride content(At time of cardiac magnetic resonance imaging)
- Correlation of kmono, kmono/RPP, FDG uptake, and myocardial triglyceride content with right ventricular function(Day 1)
- Correlation of kmono, kmono/RPP, FDG uptake, and myocardial triglyceride content with six minute walk distance(Day 1)
研究者
Evan Brittain
Assistant Professor of Medicine
Vanderbilt University Medical Center