Effect of Aldosterone on Energy Starvation in Heart Failure
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/24/2019 |
| Start Date: | December 2007 |
| End Date: | July 2020 |
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).
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.
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.
Inclusion Criteria:
- 18 years or older
- Nonischemic dilated cardiomyopathy
- Left ventricular ejection fraction 35% or less
- Stable heart failure symptoms
- Able to undergo both positron emission tomography and magnetic resonance imaging with
gadolinium
- Able to tolerate treatment with spironolactone
Exclusion Criteria:
- Serum potassium >5.0
- Serum creatinine >2.5
- Contraindications to magnetic resonance imaging such as internal
cardioverter-defibrillator.
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