Altering Substrate Selection as a Potential Therapeutic Target in Heart Failure

Research summary

The normal heart can use either sugar or fat to produce the energy needed to pump. If the amount of sugar and fat change in the blood (for example after eating or fasting) the normal heart is flexible and will use either depending on what is available in the blood. When the heart speeds up during exercise it prefers to use glucose as this is readily available and provides energy quickly. One of the changes that occurs in heart failure is that the heart cannot use sugar, loses its flexibility to change fuel when needed, and can only use fat. When the failing heart is made to exercise it cannot use sugar which limits its ability to produce energy quickly. This study aims to find out of whether heart function and energy production can be improved in heart failure by changing the fuel (sugar or fat) the heart uses for pumping. We also hope to find out whether switching the fuel from fat to sugar improves the pumping function in patient with heart failure during exercise. Our study will use an imaging technique that is able to show how much sugar the heart is using. This technique called hyperpolarized Magnetic Resonance Imaging (MRI) has been used in other fields of medicine before, and is powerful enough for us to watch how the heart changes the way it uses fuels (such as sugars and fat) to produce energy. It will also use specialized MRI scans to measure energy levels in the heart. We are recruiting 10 healthy volunteers to the study and also 15 patients with heart failure who are scheduled to have a cardiac pacemaker implanted as part of their treatment to have these scans. We will also make measurements of heart function and fuel use during the pacemaker implantation.

Principal Investigator

Prof Oliver Rider

Contact us

Email: cvm_nurses@cardiov.ox.ac.uk

IRAS number

236881