Defining the Role of Insulin Resistance in 'Idiopathic' Dilated Cardiomyopathy

Study Overview
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Brief Summary
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This study will investigate the effects of rosiglitazone, a medicine commonly used to treat type 2 diabetes, on the utilization of glucose by the heart in patients with heart failure which is not due to heart attacks. The primary purpose of the study is to determine whether treatment with an insulin-sensitizing medication will improve the heart's ability to metabolize glucose (sugar).

Detailed Description
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Nondiabetic patients with nonischemic cardiomyopathy who are insulin-resistance or insulin-sensitive based on a fasting homeostasis model assessment (HOMA) value are eligible for the trial. At baseline, a 6-minute walk test is performed, followed by assessment of coronary flow reserve with ammonia-PET imaging before/after adenosine infusion. Subjects are then given an oral glucose load (75g), followed by PET imaging with F-18-fluoro-2-deoxyglucose (FDG). Subjects then begin taking rosiglitazone 4 mg qd x 12 weeks, after which the 6-minute walk test & PET imaging is repeated.

Official Title
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Defining the Role of Insulin Resistance in 'Idiopathic' Dilated Cardiomyopathy

Conditions
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Dilated Cardiomyopathy

Intervention / Treatment
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* Drug: Rosiglitazone therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of nonischemic dilated cardiomyopathy, current NYHA class I-II congestive heart failure History of Stage C-D heart failure with EF ≤ 40% during the course of the disease Treatment with a stable comprehensive heart failure regimen for at least 3 months (including beta-blockers and ACE-inhibitors or angiotensin receptor blockers unless intolerant) Age > 18 yrs Exclusion Criteria: Cardiomyopathy due to one of the following: Ischemic heart disease Primary valvular lesion Hypertrophic cardiomyopathy Cardiac resynchronization within the last 3 months Transaminase values > 2.5 x upper limit of normal or history of liver disease Diagnosis of diabetes mellitus by: Diabetes previously diagnosed per patient history 2 or more fasting glucose values > 125 mg/dl Current NYHA class III or IV heart failure Serum creatinine > 1.6 mg/dl History of heart transplantation Pregnancy or active breast feeding Hospitalization for decompensated heart failure within 30 days prior to enrollment.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Rosiglitazone therapy|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myocardial glucose uptake (intrasubject before/after rosiglitazone) |  |  | 
| Myocardial glucose uptake (between insulin-resistant & insulin-sensitive groups) |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coronary flow-reserve |  |  | 
| 6-minute walk time |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nonischemic dilated cardiomyopathy