Coronary blood flow regulation in HFpEF and AF
Research type
Research Study
Full title
Effects of atrial fibrillation on coronary blood flow regulation in heart failure with preserved ejection fraction
IRAS ID
268439
Contact name
Ajay M. Shah
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Half of all patients with heart failure appear to have normal heart pumping function, known as heart failure with preserved ejection fraction (HFpEF). There is currently no proven therapy for HFpEF. Many of these patients develop an abnormal heart rhythm, known as atrial fibrillation (AF), which is often accompanied by worse symptoms. The aim of this study is to determine whether patients with HFpEF and AF have reduced coronary blood flow (blood flow to the heart) compared to patients with HFpEF who do not have AF, and to determine whether coronary blood flow is related to heart function. This information will help us to better understand the cause of symptoms in HFpEF, and eventually develop new treatments for this condition. \n\nWe will study 96 patients with HFpEF, with and without AF, who are already undergoing cardiac catheterisation for clinical reasons. Cardiac catheterisation is an X-ray based investigation during which small diameter catheters are introduced into the heart to image the coronary arteries and measure the pressure in the heart’s chambers. \n\nImmediately after the patient’s clinically indicated procedure, we will use special catheters to measure coronary blood flow and the pressure and volume in the heart’s main pumping chamber (left ventricle). These catheters are very similar to those used in clinical practice. Measurements will be taken when the patient is lying still, after a brief period of hand or leg exercise, and during a brief infusion of one of the following drugs that can increase or decrease coronary blood flow: either sodium nitrite, L-NMMA (NG-mono-methyl-ʟ-arginine), SMTC (S−methyl−L−thiocitrulline), or saline (comparison group). We have safely used these drugs in more than 200 patients in this department without causing any major side-effects. Once the infusion has been stopped, there are no lasting effects, and this will be the end of the study.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
19/SC/0627
Date of REC Opinion
22 Jan 2020
REC opinion
Further Information Favourable Opinion