Evidence mapPaperPMID 41711740Full record

ArticleESC heart failure2026

Metformin inhibits proliferation of residing fibroadipogenic progenitor cells from failing human hearts.

Anders Hostrup Larsen, Lin Lin, Andreas Buch Møller, Jean Farup, Lars Poulsen Tolbod, Tine Billeskov, Jonas Brorson, Elias Immanuel Ordell Sundelin, Steen Jakobsen, Helene Nørrelund and 9 more

Registry-linked trialAbstract readClinical Trial, Phase I
In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03122769. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03122769 phase1completed

Cardiac Uptake of Metformin and Expression of Metformin Membrane Transporter Proteins in the Human Failing Myocardium

Ran2017Enrolled6Registered outcomes1Posted comparisons0ConditionsHeart Failure, SystolicArms11C-metformin
Open the trial in the graph
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Anders Hostrup LarsenSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.ORCID 0000-0003-1127-6910
Lin LinSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Andreas Buch MøllerSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Jean FarupSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Lars Poulsen TolbodDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Tine BilleskovSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Jonas BrorsonSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Elias Immanuel Ordell SundelinSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Steen JakobsenDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Helene NørrelundDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Hendrik Johannes HarmsDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Nils Henrik HanssonDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Steen Bønløkke PedersenSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.
Lars Christian GormsenDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Yonglun LuoSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.ORCID 0000-0002-0007-7759
Frank Vincenzo de PaoliDepartment for Biomedicine, Aarhus University, Aarhus, Denmark.
Jørgen FrøkiærDepartment of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Henrik WiggersDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Niels JessenSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus DK-8200, Denmark.ORCID 0000-0001-5613-7274

Funding

Aase and Ejnar Danielsen Foundation 10-001657A.P. Møller FoundationArvid Nilsson Foundation Dok1780631Augustinus Foundation 15-4919Danish Diabetes AcademyDanish Diabetes AssociationDanish Heart Foundation 15-r99-a5947-22032Danish Heart Foundation 15-r99-a5947-22933Health Faculty at Aarhus University phd0115Health Research Fund of Central Denmark RegionHede Nielsen FoundationHelga and Peter Korning Foundation 55027-100Independent Research Fund Denmark 4183-00384Independent Research Fund Denmark 5053-00195Independent Research Fund Denmark 8048-00072AKirsten Anthonius Memorial FundLundbeck Foundation R396-2022-350Novo Nordisk Foundation NNF13OC0003882Novo Nordisk Foundation NNF21OC0071718Novo Nordisk Foundation NNF21OC0072031Novo Nordisk Foundation OL8201P.A. Messerschmidt & Hustrus Foundation
6 · The paper itself

Abstract

introductionEvidence from randomized trials indicates beneficial effects of metformin treatment in heart failure with reduced ejection fraction (HFrEF), but mechanisms of action remain elusive. We investigated myocardial metformin distribution in vivo in HFrEF patients and explored its effects on cardiac fibrogenic progenitor cells from human HFrEF hearts in vitro.

methodsWe assessed myocardial metformin distribution and its dependency on myocardial viability in seven HFrEF patients (ejection fraction: 36 ± 8%; median age: 67 years) using 11C-metformin positron emission tomography (PET), 15O-H2O-PET, and exercise stress echocardiography. We characterized myocardial cellular composition by fluorescence-activated cell sorting and single-cell RNA sequencing (scRNA-seq) on mononuclear cells isolated from explanted left ventricles from four HFrEF patients and four control human hearts. A population of fibroadipogenic progenitor cells (FAPs) was identified and incubated after differentiation with metformin to test the effects on proliferation.

resultsMyocardial 11C-metformin kinetics were best described by reversible two-tissue-compartment kinetics. Global myocardial metformin net influx rate was 0.012 ± 0.007 ml ml-1 min-2, and the myocardium-to-blood ratio was 1.24 (95% confidence intervals: 1.03-1.44; P < .001) after 90 min. Regional myocardial metformin net influx correlated inversely with myocardial viability (r = -0.65, P = .04). By scRNA-seq, we identified cardiac FAPs expressing CD34 and PDGFRA, which transformed into extracellular matrix-forming myogenic cells upon activation. Incubation with metformin in clinically relevant doses (0.1 mM) inhibited FAP proliferation by 25%.

conclusionMyocardial metformin uptake in HFrEF is marginal and confined to less viable and fibrotic regions. Cardiac FAPs are resident in human HFrEF myocardium and exhibit fibrogenic potential. Metformin inhibits FAP activation and proliferation at clinically relevant concentrations. These findings suggest that metformin may attenuate adverse left ventricular remodelling by targeting cardiac FAPs. CLINICAL

trial registrationhttps://clinicaltrials.gov. Unique identifier: NCT03122769.

Indexed as

Cell ProliferationHeart FailureHeart VentriclesMetforminMyocardiumStem CellsStroke VolumeAgedCells, CulturedFemaleHumansHypoglycemic AgentsMaleMiddle AgedPositron-Emission TomographyHypoglycemic AgentsMetforminFAPsFibrosisHeart failureMetforminProgenitor cellsStem cells

Identifiers

PMID41711740
PMCPMC13108281

What Socratic holds

Texttitle and abstract
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.