Diabetes and Cardiac Energy Metabolism (DICE)
Research type
Research Study
Full title
Diabetes and Cardiac Energy Metabolism
IRAS ID
297096
Contact name
Eylem Levelt
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
We will recruit patients with and without type 2 diabetes (T2D) undergoing valve surgery for severe valve disease (any type of valve dysfunction including aortic valve, mitral valve or tricuspid valve either with regurgitation or stenosis) or coronary artery bypass grafting (CABG) surgery for ischemic heart disease. As aortic stenosis and mitral regurgitation are the most common forms of valve disease in the UK, we expect most valve disease patients to fall into one of this groups. We will obtain myocardial biopsy samples from the right atrial appendage and (if feasible) also a small pea sized sample from the ventricular septum to study the mitochondrial function. We will explore how mitochondrial function changes when ketones are available to the tissue as an energy fuel. Epicardial and subcutaneous adipose tissue biopsy samples will also be obtained at the time of surgery before initiation of cardiopulmonary bypass. We will characterize these fat tissue types by microscopy. We will scan patients with an MRI scanner within one month before surgery to assess heart function, energy levels, epicardial fat levels and scarring of the heart. In patients with valve disease, we will also explore blood supply of the heart during the scan by giving a drug called adenosine to mimic exercise activity. This assessment will not take place in patients with coronary artery disease (CAD) undergoing CABG surgery. 12 months after the surgery, all patients will be invited for a repeat scan with the same scan protocol they had during their first visit. This will allow us to gain additional information on how presence of diabetes impact on surgical outcomes and myocardial recovery compared to patients undergoing the same type of surgical procedures without diabetes.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
21/NW/0135
Date of REC Opinion
9 Jun 2021
REC opinion
Further Information Favourable Opinion