Clinical trial

Myocardial Metabolic Flux in Pulmonary Arterial Hypertension

Opening soon · Phase 2 · 0 countries · Registry ID NCT07737522

Opening soonPhase 2Interventional

What this study is about

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).

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to 85 Years
SexAll
Healthy volunteersNot accepted
ConditionPulmonary Arterial Hypertension

Full registry 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

Treatments and study arms

GLP-1 agonist

Drug

Semaglutide

Primary outcomes

Change in the phosphocreatine-to-adenosine triphosphate (31PCr/ATP) ratio between baseline and follow up in response to treatment with GLP-1 agonist12 weeks

Study locations

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No public site location was included in this record. Check the original registry for updates.