Myocardial Metabolism in Patients With Dilated Cardiomyopathy

Abnormal Glucose Tolerance is Associated With a Reduced Myocardial Metabolic Flexibility in Patients With Dilated Cardiomyopathy

Status

UNKNOWN

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02440217

Enrollment

Registered

2015-05-12

Start date

2015-05-31

Completion date

2015-06-30

Last updated

2015-05-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Dilated Cardiomyopathy, Type 2 Diabetes

Brief summary

Dilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. The investigators aimed at verifying whether this pattern is influenced by the presence of abnormal glucose tolerance (AGT).

Detailed description

A catheter is advanced into the coronary sinus by fluoroscopy to withdraw venous blood. A unipolar pacing catheter is positioned into the right atrium. Arterial sampling is done from the femoral artery introducer catheter. The study protocol consisted of 3 steps (Rest, Pacing and Recovery), during which timed blood samples are collected to measure plasma NEFA and glucose. After the instrumentation is completed, Rest arterio-venous sampling is performed at time -15 min and 0 min. After the 0 min, heart rate is increased by atrial pacing to 110 bpm for 3 minutes and to 130 bpm for 3 additional minutes and arterio-venous sampling is repeated at the end of each step (at time 3 and 6 min). Pacing is then stopped and at time 1, 5, 15 and 30 min into the Recovery period other pairs of arterial and venous samples are withdrawn.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

21 Years to 69 Years

Healthy volunteers

Inclusion criteria

For patients with dilated cardiomyopathy: * Myocardial left ventricular ejection fraction (LVEF) \<40% * left ventricular end-diastolic diameter (LVEDD) \>56 mm For patients without dilated cardiomyopathy: * LVEF \>50% * LVEDD \<56 mm.

Exclusion criteria

* NYHA class IV * Atrial fibrillation * Previous myocardial infarction * Valvular heart disease * Myocarditis * Pericarditis * Severe to moderate systemic arterial hypertension * Fasting hyperglycaemia (\>7.0 mmol/l) * Treated diabetes, autoimmune diseases, neoplasia, kidney, liver or respiratory failure

Design outcomes

Primary

Measure	Time frame	Description
Myocardial metabolic responses to stress in humans	Arterio-venous sampling will be performed in about an hour during three experimental condition: rest (time -15 and 0 min), pacing (3 and 6 min), and recovery (1, 5, 15 and 30 min).	The investigators aimed at evaluating myocardial NEFA and glucose uptake.

Countries

Italy

Outcome results