Extra energy for hearts with a genetic defect: ENERGY trial

Area of Science:

• Cardiology
• Biochemistry
• Genetics

Background:

• Hypertrophic cardiomyopathy (HCM) is linked to reduced myocardial energy efficiency.
• This decreased efficiency is a key factor in HCM development.
• Early intervention may prevent disease progression.

Purpose of the Study:

• To assess if metabolic drugs can correct impaired myocardial energy efficiency in HCM mutation carriers.
• To evaluate trimetazidine's effect on cardiac function in early-stage HCM.
• To establish a proof of concept for metabolic therapy in HCM.

Main Methods:

• A double-blind, randomized study involving 40 genotype-positive, phenotype-negative MYH7 mutation carriers.
• Two months of treatment with either trimetazidine or a placebo.
• Measurement of myocardial energy efficiency using [11C]-acetate PET/CT and cardiac MRI before and after treatment.

Main Results:

• Data on myocardial energy efficiency changes in response to trimetazidine are pending.
• The study will provide crucial insights into the metabolic underpinnings of early HCM.
• Analysis will focus on the correlation between oxygen consumption and cardiac work.

Conclusions:

• The ENERGY trial is the first to explore metabolic drugs as a potential preventive therapy for HCM.
• Trimetazidine shows promise for early intervention in HCM.
• Successful results could facilitate rapid clinical implementation of trimetazidine for HCM treatment.