Heart Failure, Congestive Clinical Trial
Official title:
Assessment of Metabolic Function and Perfusion Using Positron Emission Tomography: An Analysis of Patients With Congestive Cardiomyopathy Before and After Beta-Blockers
The human heart is divided into four chambers. One of the four chambers, the left ventricle,
is the chamber mainly responsible for pumping blood out of the heart into the circulation.
Diseases of the heart like congestive heart failure (CHF), can cause the left ventricle to
function improperly.
Medications called beta-blockers appear to reverse the abnormalities in the left ventricle
and frequently improve the function of the left ventricle in patients with different kinds
of heart disease. How beta-blockers improve left ventricle function is unknown.
One possible reason for improved function of the left ventricle with beta-blockers is
improved blood flow to the heart muscle. When a region of the heart is active, it uses more
fuel in the form of oxygen and sugar (glucose). As heart activity increases, blood flow to
and from the area of activity increases also. Knowing these facts, researchers can use
radioactive sugar (glucose) and positron emission tomography (PET) scans to observe what
areas of the heart are receiving more blood flow.
In this study researchers plan to measure glucose use in heart muscle and blood flow to the
heart muscle in patients with CHF taking beta-blockers.
Deterioration in left ventricular function, which is characteristic in patients with congestive heart failure, appears to be a multifactorial process. Beta-blockers appear to reverse the deterioration and frequently improve left ventricular function in patients with both ischemic and non-ischemic cardiomyopathies. The mechanism by which beta-blockers improve ejection fraction is not known. Although it is well established that regional flow, function and metabolism may improve after coronary revascularization whether beta-blocker therapy will have similar salutary results in patients with congestive heart failure is unknown. The aim of this study is to: 1) quantitate regional glucose uptake and regional blood flow before and after chronic beta-blocker administration to patients with congestive heart failure using positron emission tomography, 2) determine if alteration in either regional glucose or lipid uptake or regional blood flow correlate with improvement in wall motion and global left ventricular function, and 3) determine if ischemic and nonischemic myocardium differ in blood flow or metabolism. ;
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