Targeted energy-repletion as a novel treatment for non-ischaemic CM
Research type
Research Study
Full title
Intravenous lipid infusion as targeted energy-repletion as a novel treatment for non-ischaemic cardiomyopathy: a pilot study
IRAS ID
167132
Contact name
Ross Breckenridge
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Heart failure is a disease that affects over 900,000 people in the UK. It has a poor prognosis, with 30-40% of all newly diagnosed patients dying within a year (Petersen et al 2002). It consists of signs and symptoms that result from the pumping action of the heart working less efficiently. The mainstay of treatment is with medication, which acts to control blood pressure and improve the pump function of the heart. While the majority of cases of heart failure in the UK are due to ischaemic heart disease, there is a significant proportion that are due to heart valve problems, non-ischaemic cardiomyopathy due to inherited or drug-related causes such as cancer treatments and alcohol, and irregular rhythms of the heart. Although more difficult to predict due to the increased risk of sudden cardiac death, dilated cardiomyopathy (DCM) has historically had a median survival rate of approximately two years following diagnosis (Fuster et al), although this has improved in recent years (Di Lenarda et al,M).
There is evidence that failing hearts generate energy in a less efficient way than normal hearts, by burning sugar via glycolysis rather than fat by oxidative phosphorylation. As a consequence of the different energetics of these two processes, the failing heart has less energy available to it at the expense of maintaining adequate oxygen levels. Our trial is a pilot study that aims to investigate whether or not supplying more energy to the cardiac cells or myocytes will improve energetics and thus cardiac function. Our proposed patient group will have non-ischaemic, rather than ischaemic, cardiomyopathy. The trial will involve administering Intralipid™ lipid emulsion intravenously, and assessing cardiac function before and after treatment with cardiac magnetic resonance imaging (MRI)/positron emission tomography (PET)-MR and echocardiography. Blood and urine samples will be taken before and after the lipid is administered for metabolite analysis. The study will take place over two days, with baseline imaging and tests performed on day one and the lipid emulsion administered on day two, with repeat imaging and tests afterwards.REFERENCES:
Petersen S, Rayner M and Wolstenholme, J ‘Coronary heart disease statistics: Heart failure supplement’, 2002. British Heart Foundation (BHF)Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO and Frye RL ‘The natural history of idiopathic dilated cardiomyopathy’, Am J Cardiol, 1981, 47(3):525-31
Di Lenarda A, Secoli G, Perkan A, Gregori D, Lardieri G, Pinamonti B, Sinagra G, Zecchin M and Camerini F ‘Changing mortality in dilated cardiomyopathy’, Br Heart J 1994, 72:S46-51
Matsumura Y, Takata J, Kitaoka H, Kubo T, Baba Y, Hoshikawa E, Hamada T, Okawa M, Hitomi N, Sato K, Yamasaki N, Yabe T, Furuno T and Nishinaga M ‘Long-term prognosis of dilated cardiomyopathy revisited: an improvement in survival over the past 20 years’, Circ J, 2006, 70(4):376-83
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
15/LO/1654
Date of REC Opinion
26 Oct 2015
REC opinion
Further Information Favourable Opinion