Status:

UNKNOWN

Nutritional Ketosis in Heart Failure

Lead Sponsor:

Thomas Jefferson University

Conditions:

Chronic Heart Failure

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

Chronic, ambulatory heart failure patients will be given ketone ester dietary supplementation to determine therapeutic efficacy, metabolic adaptation, pharmacokinetics, associated cognitive changes, a...

Detailed Description

We previously demonstrated a metabolic signature of increased ketone utilization-increased peripheral blood concentration of beta-hydroxybutyrate (BHB) and decreased myocardial concentration of BHB-an...

Eligibility Criteria

Inclusion

  • Equal to or greater than 18 years of age
  • Diagnosis of heart failure and be classified as NYHA Class II or III either pre-enrollment or at the time of enrollment
  • Stable medical therapy for at least 1 month prior to enrollment
  • Taking appropriate daily cardiac medications as determined by the principal investigator, who is a heart failure specialist

Exclusion

  • Atrial fibrillation
  • Inability to exercise on a supine bicycle.
  • Moderate or greater valvular disease.
  • Hemoglobin \<10 g/dL.
  • Daily insulin use
  • Hypertrophic, infiltrative, or inflammatory cardiomyopathy.
  • Pericardial disease.
  • Current angina due to clinically significant obstructive epicardial coronary disease
  • Acute coronary syndrome or coronary intervention within the past 2 months.
  • Primary pulmonary arteriopathy.
  • Known clinically significant lung disease defined as:
  • Current use of supplemental oxygen, aside from nocturnal O2 for the treatment of obstructive sleep apnea
  • The use of steroids/antibiotics within the past 6 months for an acute exacerbation of obstructive pulmonary disease
  • Most proximal pulmonary function test indicating severe obstructive disease, defined as an FEV1\<50% predicted in the context of an FEV1/FVC ratio of \<0.70 ("Stage III COPD according to GOLD Criteria). (note: only to be used if the subject had PFTs prior to screening)
  • Most proximal 6-minute walk test during which the subject experienced arterial desaturation (\<94%) without a subsequent normal study.
  • Ischemia on stress testing without subsequent revascularization or left heart catheterization showing non-obstructive epicardial coronary disease.
  • Significant liver disease impacting synthetic function or volume control.
  • Uncontrolled hypertension: BP \>180/110 at baseline.
  • eGFR \<30 mL/min/m2 or Cr \>2.5.
  • Alcohol dependence
  • Chronic narcotic use that cannot be interrupted
  • Pregnant or lactating females

Key Trial Info

Start Date :

June 1 2020

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 1 2021

Estimated Enrollment :

16 Patients enrolled

Trial Details

Trial ID

NCT04370600

Start Date

June 1 2020

End Date

June 1 2021

Last Update

May 1 2020

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