Right Ventricular Metabolism in Pulmonary Arterial Hypertension

Sponsor

Vanderbilt University Medical Center (Other)

Overall Status

Completed

CT.gov ID

NCT02763735

Collaborator

(none)

Enrollment

Location

Duration (Months)

0.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Pulmonary Arterial Hypertension Healthy

Detailed Description

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.

Study Design

Study Type:

Observational

Actual Enrollment :

34 participants

Observational Model:

Cohort

Time Perspective:

Cross-Sectional

Official Title:

Metabolic Intervention in the Right Ventricle in Pulmonary Arterial Hypertension

Study Start Date :

Jun 1, 2014

Actual Primary Completion Date :

Jun 1, 2019

Actual Study Completion Date :

Jun 1, 2019

Arms and Interventions

Arm	Intervention/Treatment
Pulmonary Arterial Hypertension Patients diagnosed with idiopathic or heritable pulmonary arterial hypertension according to consensus guidelines. RV oxidative metabolism and glycolysis will be measured using PET 11C acetate and [18F]fluoro-deoxy-Dglucose (FDG) imaging and measure myocardial lipid accumulation using MRS imaging.
Subjects without cardiopulmonary disease Subjects without known cardiopulmonary disease. RV oxidative metabolism and glycolysis will be measured using PET 11C acetate and [18F]fluoro-deoxy-Dglucose (FDG) imaging and measure myocardial lipid accumulation using MRS imaging

Outcome Measures

Primary Outcome Measures

Right ventricular oxygen consumption divided by the rate pressure product [At time of C11 acetate PET scan]
kmono divided by the rate pressure product (heart rate X systolic blood pressure)

Secondary Outcome Measures

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]
Percent myocardial triglyceride content [At time of cardiac magnetic resonance imaging]
Percent of myocardial triglyceride measured in the interventricular septum
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]
Correlation of kmono, kmono/RPP, FDG uptake, and myocardial triglyceride content with plasma metabolic profile [Day 1]