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The heart requires nutrients and oxygen carried in the blood to generate energy for healthy pump function. Blood is supplied via heart vessels called coronary arteries. When the arteries narrow the investigators call this coronary artery disease. Narrowing and blockage of the coronary arteries can cause chest pain (angina), breathlessness (due to a reduction in pump function) and if prolonged even irreversible muscle damage known as a heart attack. The investigators can treat patients with coronary artery disease with drugs that reduce the workload on the heart or with balloons and hollow metal tubes (stents) to open the narrowed coronary arteries and improve the blood supply. These treatments can relieve angina, improve breathlessness and avert heart muscle damage during a heart attack. A potential new mechanistic effect is emerging by modulating the type of fuel used by the heart to generate energy more efficiently has been tested in the left ventricle. This study is designed to see if mechanistic effect provides the same protection in the right ventricle. It is hoped that this may further improve heart pump function and reduce the size of a heart attack in patients with coronary artery disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| saline placebo infusion | Placebo Comparator | 30 minute infusion of a saline placebo Right coronary artery percutaneous coronary intervention |
|
| GLP-1 infusion | Experimental | 30 minute infusion of GLP-1 Right coronary artery percutaneous coronary intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Right Coronary Artery Percutaneous Coronary Intervention | Procedure |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Improvement in RV diastolic dysfunction (Tau, dP/dt min) between control and GLP-1 groups. | Tau - the time constant of diastolic relaxation is a sensitive measure of ventricular function. Control Group - 15 patients are randomised to receive a placebo saline infusion. GLP-1 Group - 15 patients are randomised to receive a GLP-1 infusion. Balloon Occlusion One - is performed at the start of the procedure and is a measure of baseline ventricular function. Balloon Occlusion Two - is performed directly after a 30 minute infusion of either the saline control or GLP-1. All measurements are performed while the patient is in the catheter laboratory. | Change betweeen Balloon Occlusion One (Baseline) and Balloon Occlusion Two (30 minutes later) |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement in RV systolic function (EF, dP/dt max), between control and GLP-1 groups. | EF - the Ejection Fraction is the percentage of blood ejected by the ventricle and is considered as a sensitive measure of ventricular function. Control Group - 15 patients are randomised to receive a placebo saline infusion. GLP-1 Group - 15 patients are randomised to receive a GLP-1 infusion. Balloon Occlusion One - is performed at the start of the procedure and is a measure of baseline ventricular function. Balloon Occlusion Two - is performed directly after a 30 minute infusion of either the saline control or GLP-1. All measurements are performed while the patient is in the catheter laboratory. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Stephen P Hoole, BM BCh, MA, DM | Contact | 01480 364119 | stephen.hoole@papworth.nhs.uk | |
| Richard G Axell, BEng, MSc | Contact | 01223 348098 | richard.axell@addenbrookes.nhs.uk |
| Name | Affiliation | Role |
|---|---|---|
| Stephen P Hoole, BM BCh, MA, MD | Papworth Hospital NHS Foundation Trust | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Papworth Hospital NHS Foundation Turst | Recruiting | Cambridge | Cambridgeshire | CB23 3RE | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21586690 | Background | Read PA, Hoole SP, White PA, Khan FZ, O'Sullivan M, West NE, Dutka DP. A pilot study to assess whether glucagon-like peptide-1 protects the heart from ischemic dysfunction and attenuates stunning after coronary balloon occlusion in humans. Circ Cardiovasc Interv. 2011 Jun;4(3):266-72. doi: 10.1161/CIRCINTERVENTIONS.110.960476. Epub 2011 May 17. |
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| saline placebo infusion | Other | 30 minute placebo infusion used as a comparator to the GLP-1 infusion |
|
| GLP-1 Infusion | Other | 30 minute infusion GLP-1 |
|
| Change betweeen Balloon Occlusion One (Baseline) and Balloon Occlusion Two (30 minutes later) |
| Collaterals and microcirculatory differences between control and GLP-1 groups | Control Group - 15 patients are randomised to receive a placebo saline infusion. GLP-1 Group - 15 patients are randomised to receive a GLP-1 infusion. Balloon Occlusion One - is performed at the start of the procedure and is a measure of baseline ventricular function. Balloon Occlusion Two - is performed directly after a 30 minute infusion of either the saline control or GLP-1. All measurements are performed while the patient is in the catheter laboratory. | Change betweeen Balloon Occlusion One (Baseline) and Balloon Occlusion Two (30 minutes later) |