Myocardial Metabolic Flux in Pulmonary Arterial Hypertension
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: GLP-1 agonist.
- Who it may be relevant to
- Registry conditions: Pulmonary Arterial Hypertension. Basic parameters: 18 years — 85 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Myocardial Metabolic Flux in Patients With Pulmonary Arterial Hypertension (PAH) in Response to GLP-1 Agonist Therapy: a Physiological Study Using 31-Phosphorus MR Spectroscopy
Overview
The rationale for this study is that GLP-1 agonist treatment is likely to influence myocardial substrate utilisation, changing the predominant source of metabolic energy within the heart to a more energetically efficient form. This is represented by a surrogate for improved mitochondrial efficiency with reduction in myocardial lactate levels (produced by inefficient myocardial glycolysis, prevalent in the ventricles of patients with pulmonary hypertension), which can be measured by 31P-magnetic resonance spectroscopy (31P-MRS).
Interventions
- Drug GLP-1 agonist
Semaglutide
Primary outcome measures
- Change in the phosphocreatine-to-adenosine triphosphate (31PCr/ATP) ratio between baseline and follow up in response to treatment with GLP-1 agonist [Time frame: 12 weeks]
Eligibility criteria
Inclusion criteria
\- 1. Diagnosis of Group 1 PAH confirmed by right heart catheterisation under the National Pulmonary Hypertension Service, Royal Brompton Hospital, part of GSTT Foundation Trust 2. Age over 18, less than 85 years 3. Able to give informed consent 4. On a stable dose of PAH-specific therapies (e.g., ERA, PDE5i) for at least 3 months.
5\. Clinically justified prescription of GLP-1 agonist Semaglutide based on following criteria: BMI > 30 or BMI > 27 with at least one cardiovascular co-morbidity (systemic hypertension, diabetes, pre-diabetes, COPD, atrial fibrillation, dyslipidaemia, sleep disordered breathing)
Exclusion criteria
- • 1. Pregnancy
- 2\. Myocardial infarction within the previous 3 months
- 3\. Contraindications to MRI: Pacemakers, metallic implants, or severe claustrophobia.
- 4\. Severe renal impairment: eGFR < 15ml/min/1.73m.
- 5\. Current use of SGLT2 inhibitors or GLP-1 agonist therapy (which significantly alter fuel substrate preference) or insulin therapy that cannot be held for the fasting scan
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Basic science
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07737522 · 370988