Effect of Isoflurane on Tissue Doppler Imaging of Mitral Annulus During Cardiac Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Peak mitral annular velocity during systole(S')
研究概览
简要总结
The purpose of this study is to determine Isoflurane's dose-dependent effect on left ventricular (LV) systolic function in cardiac surgery. The change of tissue Doppler imaging (TDI) of lateral mitral valve annular systolic velocity at three different isoflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (TEE) in cardiac surgery patients.
详细描述
Isoflurane is widely used in cardiac surgery patients due to its beneficial effects, but many studies have shown that isoflurane reduces myocardial contractility in a dose-dependent manner, and compromises left ventricular (LV) function.
Tissue Doppler imaging (TDI) of mitral annular velocity during the cardiac cycle has been introduced as a reliable method for analysis of systolic and diastolic LV long-axis function. Efficacy of systolic and diastolic TDI profiles, including systole (S'), early early relaxation (E')and atrial contraction (A') have been suggested to be useful in predicting the impact of isoflurane on LV systolic and diastolic function.
The investigators hypothesized that isoflurane, even at a clinical dosage, would affects intraoperative LV systolic function in a dose-dependent manner and thus produce significant changes int the TDI profiles of systolic mitral annular velocity (S').
So the investigators planned to study the changes in S' of lateral mitral annulus at the clinical isoflurane dosage during remifentanil based anesthesia for cardiac surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients undergoing cardiac surgery
排除标准
- •low ejection fraction < 50% in preoperative transthoracic echocardiography
- •atrial fibrillation
- •pacemaker
- •pericardial and infiltrative myocardial disease
- •mitral annular calcification, surgical rings, prosthetic mitral valves
- •lateral left ventricular regional wall motion abnormality
- •esophageal spasm, stricture, laceration, perforation, and diverticulum diaphragmatic hernia
- •history of extensive radiation to mediastinum
- •upper gastrointestinal bleeding
研究组 & 干预措施
Isoflurane 1.0 MAC
10 min-inhalation of each concentration of isoflurane, 1.0 MAC
干预措施: Isoflurane 1.0 MAC (Drug)
Isoflurane 1.5 MAC
10 min-inhalation of each concentration of isoflurane, 1.5 MAC
干预措施: Isoflurane 1.5 MAC (Drug)
Isoflurane 2.0 MAC
10 min-inhalation of each concentration of isoflurane, 2.0 MAC
干预措施: Isoflurane 2.0 MAC (Drug)
结局指标
主要结局
Peak mitral annular velocity during systole(S')
时间窗: after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC
By using pulsed Doppler with the sample volume positioned at the lateral mitral valve (MV)ring in the midesophageal 4-chamber view, S' would be determined just after the 10 min-exposure to each concentration of isoflurane, 1.0 MAC, 1.5 MAC and 2.0 MAC (T1, T2 and T3, respectively)
次要结局
- ejection fraction(EF)(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
- peak velocity of mitral inflow during atrial contraction(A)(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
- Peak mitral annular velocity during atrial contraction(A')(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
- peak velocity of mitral inflow during early relaxation(E)(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
- Peak mitral annular velocity during early diastole(E')(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
- bispectral index(BIS)(after 10 min exposure to isoflurane 1.0 MAC, 1.5 MAC and 2.0 MAC)
研究者
Tae-Yop Kim, MD PhD
Professor of Anesthesiology
Konkuk University Medical Center