Pulmonary Arterial Hypertension, Right-Sided Heart Failure
Conditions
Keywords
pulmonary arterial hypertension, right-sided heart failure, metabolism, PET/MRI
Brief summary
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.
Detailed 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.
Interventions
OTHERPET/MRI
Positron Emission Tomograph/Magnetic Resonance Imaging - participants will undergo PET/MRI prior to initiation of pulmonary vasodilator therapy and again 4-6 months after initiation of therapy
Sponsors
United Therapeutics
University of Wisconsin, Madison
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ability to augment glucose uptake (substrate flexibility), defined as change in rate of glucose uptake from rest to exercise | 6 months | Substrate flexibility is defined as the change in myocardial to blood pool glucose uptake rate from rest to exercise. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in substrate flexibility after initiation of pulmonary vasodilator therapy | 6 months | Substrate flexibility is defined as the change in myocardial to blood pool glucose uptake rate from rest to exercise. Substrate flexibility before and after pulmonary vasodilator therapy will be compared. |
Countries
United States
Outcome results
None listed