Sex and Obesity: Effects on Heart Failure Study

Washington University School of Medicine19 enrolled

Overview

Sex has a major impact on myocardial metabolism and blood flow. In those without heart failure men's hearts tend to use proportionally more glucose and women's hearts use more fat and have higher blood flow. Obesity is a major risk factor for Heart Failure. In those without heart failure, increasing body mass index is predictive of increased blood flow and fatty acid metabolism in women, but not men. To measure blood flow and metabolism we used radioactive materials and a PET (positron emission Tomography) scan to study the blood flow and substrate metabolism of the heart. Hypotheses: 1) Women with heart failure with reduced ejection fraction (HFrEF) will have higher levels of heart blood flow and fatty acid metabolism and lower glucose metabolism rates than men with HFrEF. A secondary Aim was to test the hypothesis that body mass index (BMI), a measure of obesity, correlated with myocardial blood flow and myocardial metabolism measures in patients with HFrEF.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Obesity Heart Failure

Interventions

PET (Positron Emission Tomography)

This is a diagnostic scan that requires the injection of radioactive tracer compounds intravenously using an IV placed in the arm.

EchocardiogramPROCEDURE

An echocardiogram is an ultrasound of the heart. Participants received a complete 2D- and Doppler echocardiographic examination on the day of the PET scan.

^15O-waterRADIATION

This is a radioactive tracer used to study blood flow in the heart during the PET scan. It was administered intravenously at a dose of 20 mCi.

1-^11C-palmitateRADIATION

This is a radioactive tracer used to study fatty acid usage in the heart during the PET scan. It was administered intravenously at a dose of 20 mCi.

1-^11C-glucoseRADIATION

This is a radioactive tracer used to study glucose usage in the heart during the PET scan. It was administered intravenously at a dose of 20 Mci..

Eligibility

Sex: ALLMin age: 20 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion criteria * Heart failure (HF) and a systolic ejection fraction \<45% per a recent echocardiogram report) * Nonischemic HF New York Heart Association Class II-III * Ambulatory * Able to give informed consent * On a stable medical regimen including the standard-of-care HF medications (i.e., a beta-blocker, ACE-inhibitor or angiotensin receptor blocker \[ARB\]) Exclusion criteria * Participants who were pregnant or lactating * Actively losing weight * Nonsedentary (performing aerobic exercise \> 30 minutes x 3 times/week) * Those who have more than Class I hypertension * Those who require alterations in beta-blocker or ACE or ARB-inhibition medication * Those with hypertrophic, constrictive, or restrictive cardiomyopathies * Those unable to lie flat in the PET scanner * Severe major organ system dysfunction (other than heart failure) * Significant coronary artery disease by catheterization * Those unable to give informed consent

Locations (1)

Washington University School of Medicine

St Louis, Missouri, United States

Outcomes

Primary Outcomes

Average Myocardial Blood Flow

Myocardial blood flow (MBF) was measured using \^15O-water injected intravenously intravenously through a large bore catheter into an antecubital vein during the (Positron Emission Tomography (PET) scan on Study Day 2.

Time frame: Study Day 2

Secondary Outcomes

Average Myocardial Fatty Acid Utilization

Myocardial fatty acid (FA) utilization was measured using 1-\^11C-palmitate injected intravenously through a large bore catheter into an antecubital vein during the (Positron Emission Tomography (PET) scan on Study Day 2.

Time frame: Study Day 2

Data from ClinicalTrials.gov

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