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NCT Number: NCT07737522

Myocardial Metabolic Flux in Pulmonary Arterial Hypertension

The rationale for this study is that GLP-1 agonist treatment is likely to influence myocardial substrate utilisation, changing the predominant source of metabolic energy within the heart to a more energetically efficient form. This is represented by a surrogate for improved mitochondrial efficiency with reduction in myocardial lactate levels (produced by inefficient myocardial glycolysis, prevalent in the ventricles of patients with pulmonary hypertension), which can be measured by 31P-magnetic resonance spectroscopy (31P-MRS).

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Key information

Conditions

Pulmonary Arterial Hypertension Hypertension, Pulmonary Lung Diseases Respiratory Tract Diseases

Age range

18 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 1. Diagnosis of Group 1 PAH confirmed by right heart catheterisation under the National Pulmonary Hypertension Service, Royal Brompton Hospital, part of GSTT Foundation Trust 2. Age over 18, less than 85 years 3. Able to give informed consent 4. On a stable dose of PAH-specific therapies (e.g., ERA, PDE5i) for at least 3 months.
  • Clinically justified prescription of GLP-1 agonist Semaglutide based on following criteria: BMI > 30 or BMI > 27 with at least one cardiovascular co-morbidity (systemic hypertension, diabetes, pre-diabetes, COPD, atrial fibrillation, dyslipidaemia, sleep disordered breathing)

Exclusion criteria

  • • 1. Pregnancy
  • 2. Myocardial infarction within the previous 3 months
  • 3. Contraindications to MRI: Pacemakers, metallic implants, or severe claustrophobia.
  • 4. Severe renal impairment: eGFR < 15ml/min/1.73m.
  • 5. Current use of SGLT2 inhibitors or GLP-1 agonist therapy (which significantly alter fuel substrate preference) or insulin therapy that cannot be held for the fasting scan

Treatment and study plan

GLP-1 agonist

Drug

Semaglutide

Primary outcomes

  1. Change in the phosphocreatine-to-adenosine triphosphate (31PCr/ATP) ratio between baseline and follow up in response to treatment with GLP-1 agonist

    Time frame: 12 weeks

Sponsors and collaborators

Lead sponsor

Imperial College London

Other

Registry information

Official study title

Myocardial Metabolic Flux in Patients With Pulmonary Arterial Hypertension (PAH) in Response to GLP-1 Agonist Therapy: a Physiological Study Using 31-Phosphorus MR Spectroscopy

Important dates

Study start
2026
Primary completion
2028
Study completion
2029
First posted
Jul 30, 2026
Registry last updated
Jul 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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