Myocardial Metabolic Flux in Pulmonary Arterial Hypertension

NCT07737522 | Not Yet Recruiting Phase 2

• 1 other identifier: 370988
• Study Type: interventional
• Target: 32
• Locations: 0 countries
• Sites: N/A

Brief Summary

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).

Conditions

Pulmonary Arterial Hypertension

Outcome Measures

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

  12 weeks

Study Arms (1)

Standard of care

ACTIVE COMPARATOR

Drug: GLP-1 agonist

Interventions

GLP-1 agonist DRUG

Semaglutide

Standard of care

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- 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)

You may not qualify if:

• 1. Pregnancy
• \. Myocardial infarction within the previous 3 months
• \. Contraindications to MRI: Pacemakers, metallic implants, or severe claustrophobia.
• \. Severe renal impairment: eGFR \< 15ml/min/1.73m.
• \. 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

Sponsors & Collaborators

• Imperial College London: lead

MeSH Terms

Conditions

Pulmonary Arterial Hypertension

Condition Hierarchy (Ancestors)

Hypertension, Pulmonary; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 27, 2026
• First Posted: July 30, 2026
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): October 1, 2028
• Study Completion (Estimated): April 1, 2029
• Last Updated: July 30, 2026

Record last verified: 2026-07