Cardiac Metabolic Remodeling After Pulmonary Vasodilator Therapy in Pulmonary Arterial Hypertension: A Pilot Study

University of Wisconsin (UW)

Status: Terminated

Conditions: Right-Sided Heart Failure; Pulmonary Arterial Hypertension

Treatments: Other: PET/MRI

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT04090866

A534285 (Other Identifier)

SMPH/MEDICINE/MEDICINE*P (Other Identifier)

2019-0286

Protocol Version 8/2/2019 (Other Identifier)

Details and patient eligibility

About

Pulmonary arterial hypertension(PAH) is associated with the development of right heart failure. In the setting of heart failure, the heart shifts to increasing dependence on glucose metabolism. In this study, the investigators will perform cardiac positron emission tomography/magnetic resonance imaging (PET/MRI) scans to measure glucose metabolism in the heart before and after initiation of pulmonary vasodilator therapy for pulmonary arterial hypertension.

Full description

Pulmonary arterial hypertension is associated with the development of right heart failure. In the setting of heart failure, the heart shifts to increasing dependence on glucose metabolism. In this study, the investigators will perform cardiac positron emission tomography/magnetic resonance imaging (PET/MRI) scans to measure glucose metabolism in the heart before and after initiation of pulmonary vasodilator therapy for pulmonary arterial hypertension. By utilizing a rest-exercise protocol and continuous PET imaging acquisition, we can capture real-time changes in glucose uptake in the heart in response to acute exercise. By coupling these measures of dynamic glucose utilization with MRI-based cardiac function, we will determine cardiac metabolic efficiency.

Enrollment: 2 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• World Health Organization(WHO) group PAH secondary into idiopathic pulmonary arterial hypertension(IPAH) or connective tissue disease associated pulmonary arterial hypertension (CTDPAH)
• New York Heart Association (NYHA) classification I - III heart failure
• Vasodilator therapy naive
• Able to provide informed consent

Exclusion criteria

• Metabolic disorders such as uncontrolled diabetes (A1c > 8%) that may interfere with FDG uptake
• Baseline 6-minute walk distance (6MWD) < 400 feet or NYHA class IV heart failure
• Musculoskeletal abnormalities that would prevent exercise
• Contraindications to MRI