DAPA-ENERGY
Research type
Research Study
Full title
Non-ionizing Metabolic Imaging for predicting the effect of and guiding Therapeutic Interventions (MITI) sub-study: Does Dapagiflozin restore cardiac energy metabolism in diabetic heart failure patients?
IRAS ID
320757
Contact name
Stephen Hoole
Contact email
Sponsor organisation
Royal Papworth Hospital NHS Foundation Trust
Duration of Study in the UK
1 years, 9 months, 31 days
Research summary
SGLT-2 inhibitors are a unique family of drugs in that they have been found to be beneficial in patients with heart failure with both reduced ejection fraction (where there is a deficit in the ability to pump blood out) and heart failure with preserved ejection fraction (where there are more complex deficits in the filling of the heart or its ability to respond to stress). However, their mechanism is still debated. One hypothesis is that they alter cardiac glucose metabolism and energy availability within the heart muscle cell.
In this study, we will use a novel ultra-high field (7T) metabolic MRI approach to investigate the metabolic response to the SLGT-2 inhibitor, dapagiflozin. In other words, we will evaluate the concentration of specific molecules inside the muscle of the heart using a new non-invasive MRI scan.
The molecules of interest in our study are phosphorous-containing compounds including adenosine triphosphate (ATP) and phosphocreatine (PCr) which are the energy-containing compounds required for the heart to beat. We have a secondary interest in glucose and its downstream metabolites since glucose is a key source of energy for the heart. The ratio of PCr/ATP has been shown to predict cardiac function and heart failure prognosis, while glucose metabolism gives an insight into how this energy is produced.Our aim is to assess whether this new imaging approach can demonstrate how SGLT-2 inhibitors change cardiac function and therefore develop a strategy by which similar drugs can be evaluated in future.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
23/EE/0048
Date of REC Opinion
2 May 2023
REC opinion
Further Information Favourable Opinion