Developing MRI Methods to Measure Epicardial Fat Composition and Its Role in Heart Failure With Preserved Ejection Fraction

What this Trial Is About

Researchers are studying how to improve cardiac MRI methods to better measure the composition of epicardial adipose tissue EAT and understand its relationship with heart failure with preserved ejection fraction HFpEF. The study aims to develop a rapid 3D MRI technique that reduces motion artifacts and enhances image quality, and to compare EAT fatty acid composition FAC with EAT volume in relation to cardiometabolic HFpEF. The trial also explores how treatment with a GLP-1 receptor agonist, semaglutide SEMA, affects EAT FAC and heart function in individuals with cardiometabolic HFpEF or pre-HFpEF. Participants will undergo non-contrast cardiac MRI scans, exercise echocardiography, ECG, blood tests, and physical exams. Those with cardiometabolic HFpEF or pre-HFpEF will have imaging at baseline, after a 3-month self-control period, and again after 6 months of semaglutide treatment. Semaglutide dosing starts at 0.25 mg once weekly and is increased every four weeks up to a maximum of 2.4 mg or the participants tolerated dose over 16 weeks. During the study, participants will be closely monitored with several heart imaging tests and assessments of heart function and EAT characteristics. Researchers will measure changes in EAT FAC and volume as well as heart function indicators before and after treatment. The total duration of participant involvement includes baseline assessments, a 3-month observation period, and a 9-month follow-up after semaglutide treatment initiation, allowing comparison of imaging and functional outcomes over time.

Epicardial Adipose Tissue Composition and Heart Failure With Preserved Ejection Fraction