Healthy, Pulmonary Arterial Hypertension
Conditions
Keywords
Pulmonary arterial hypertension, Right ventricle, Right ventricular function, Metabolism, Non-invasive imaging, Healthy Subjects
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.
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.
Interventions
None listed
Sponsors
Vanderbilt University Medical Center
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Heritable or idiopathic PAH * 18 years or older * Able to give informed consent
Exclusion criteria
* Pregnancy * Type 1 diabetes mellitus * Prednisone use * PAH associated with any condition other than idiopathic or heritable * Implanted ferromagnetic material incompatible with MRI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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 |
| Right ventricular oxygen consumption (kmono) | At time of C11 acetate PET scan | — |
| 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 | — |
| Correlation of kmono, kmono/RPP, FDG uptake, and myocardial triglyceride content with right ventricular function | Day 1 | — |
Countries
United States
Outcome results
None listed