We plan to study the concept of "energy starvation" in heart failure by evaluation of patients with nonischemic dilated cardiomyopathy (NIDCM) (heart failure with reduced heart pump function due to causes other than heart attack). We will use a combination of positron emission tomography and magnetic resonance imaging to study metabolism, anatomy, function, blood flow and efficiency, before and after 6 months' treatment with the drug spironolactone which blocks the deleterious effects of the hormone aldosterone on the myocardium (heart muscle).
Preliminary results showed reduced subendocardial myocardial perfusion reserve in NIDCM compared to normal subjects, and that the degree of impaired perfusion reserve was related to the oxidative metabolic rate as measured by positron emission tomography.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
16
spironolactone 50 mg daily for 6 months
Vanderbilt Heart and Vascular Institute
Nashville, Tennessee, United States
Left Ventricular Work-metabolic Index (WMI) at Baseline
WMI=\[left ventricular stroke work/decay rate of 11C-acetate\]
Time frame: baseline
Left Ventricular Work-metabolic Index (WMI) at 6 Months
WMI=\[left ventricular stroke work/decay rate of 11C-acetate\]
Time frame: 6 months
Myocardial Perfusion Reserve Index (MPRI) by Magnetic Resonance Imaging at Baseline
MPRI =calculated myocardial perfusion reserve index based on Gadolinium accretion into myocardium. MPRI was calculated as the ratio of stress/rest relative perfusion upslope, corrected for LV cavity upslope.
Time frame: baseline
Myocardial Perfusion Index Reserve (MPRI) by Magnetic Resonance Imaging at 6 Months
MPRI =calculated myocardial perfusion reserve index based on Gadolinium accretion into myocardium. MPRI was calculated as the ratio of stress/rest relative perfusion upslope, corrected for LV cavity upslope.
Time frame: 6 months
Change in Myocardial Fibrosis (T1 Time) by Magnetic Resonance Imaging
T1=left ventricular relaxation rate on magnetic resonance imaging, which is correlated with interstitial fibrosis.
Time frame: baseline and 6 months
6 Minute Walk Test (6MWT) at Baseline
6MWT assesses distance walked over 6 minutes
Time frame: baseline
6 Minute Walk Test (6MWT) at 6 Months
6MWT assesses distance walked over 6 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 6 months
Minnesota Living With Heart Failure Questionnaire,at Baseline
The questionnaire is comprised of 21 important physical, emotional and socioeconomic ways heart failure can adversely affect a patient's life. Each question is scored from 0 (none or not applicable) to 5 (very much). Total scores range from 0-105. Low scores indicate less adverse impact, while higher scores reflect more adverse impact of heart failure.
Time frame: baseline
Minnesota Living With Heart Failure Questionnaire.at 6 Months
The questionnaire is comprised of 21 important physical, emotional and socioeconomic ways heart failure can adversely affect a patient's life. Each question is scored from 0 (none or not applicable) to 5 (very much). Total scores range from 0-105. Low scores indicate less adverse impact, while higher scores reflect more adverse impact of heart failure.
Time frame: 6 months