Understanding heart metabolism in diabetes and aortic stenosis

The Impact of Type 2 Diabetes on Cardiac Metabolic Phenotype in Patients with Severe Aortic Stenosis

People with aortic stenosis (a narrowing of the aortic valve opening) often also have type 2 diabetes. Having diabetes can affect how well people recover from having their aortic valve replaced, but it is not known why. The heart is hard-working and needs plenty of energy to keep pumping. In people with aortic stenosis, the heart switches its preferred energy source from using fat to using sugar. On the other hand, in people with diabetes, the heart muscle prefers to burn fat, as opposed to sugar. Exactly how the heart’s metabolism alters in people who have both conditions is not fully understood. Dr Eylem Levelt is leading a new research project that will closely investigate 160 patients who are scheduled to undergo aortic valve replacement. In this project, a Clinical Research Training Fellow working with Dr Levelt aims to understand how the heart uses fuel for energy, and whether it tends to favour burning sugar or fat in patients with severe aortic stenosis. They also wants to see whether aortic stenosis and diabetes work together to create a harmful fat and sugar environment in the body, potentially leading to damaged heart muscle that prevents healthy recovery following aortic valve replacement surgery. New treatments for aortic stenosis work by targeting the heart’s preference for burning fat. This study will provide important evidence about whether these treatments would be safe in people with aortic stenosis and diabetes, due to potential differences in heart metabolism.