TO KNOW THE INCIDENCE OF CARDIOVASCULAR ABNORMALITY IN HYPERTENSIVE PATIENTS UNDERGOING NEUROSURGICAL PROCEDURES:

Completed

Conditions: Malignant neoplasm of brain, unspecified,

Registration Number: CTRI/2021/11/037893

Lead Sponsor: PGIMER Chandigarh

Brief Summary: The study will be started after getting approval institutional ethics committee (IEC) and written informed consent from the patients. The study participant will be enrolled following registration in clinical trial registry-India (CTRI). All patients will have a thorough history taking, physical examination and checking of all the required investigations during pre- anaesthesia check-up. Patientâ€™s neurological status by the Glasgow coma scale (GCS) will be noted. Patients will be assessed for the study according to the inclusion and exclusion criteria.Baseline cardiovascular examination will be done in the preoperative holding area. Pre- procedure heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse oximetry (SpO2) will be recorded as baseline values. Preoperative electrogardiogram (ECG) will be reviewed.

ABNORMAL ECG: Changes pertaining to ECG will be considered abnormal if any of the following findings will be seen in ECG

Atrioventricular block grade 1, 2, 3. Left Ventricular Hypertrophy (LVH) defined by different voltage criteria. Heart rate <60 beats per minute as bradycardia and heart rate>100 beats per as tachycardia.

TRANSTHORACIC ECHOCARDIOGRAPHY: TTEwill be done in all the patients enrolled in the study in the preoperative holding area. TTE will be done by an experienced anesthesiologist under the guidance of a cardiac anaesthesiologist using a P21x, 5-1 MHz 21 mm broadband phased array probe of a portable echocardiographic machine. The required ECHO image and video will be recorded and subsequently evaluated by a cardiologist and/or cardiac anaesthesiologist for further analysis.

Cardiac status will be checked in the following view

1. Parasternal long-axis view

2. Parasternal short-axis view at basal, mid papillary and apical levels

3. Apical 4 chamber view

4. Apical 2 chamber view

5. Apical 5 chamber view

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With echocardiography following cardiac function will be assessed:

a. LV Systolic function by calculating LV Ejection Fraction by using Simpsonâ€™s biplane method b. LV Diastolic dysfunction by using pulse wave mitral inflow velocity and mitral septal annular tissue Doppler imaging

c. graded

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ABNORMAL ECHOCARDIOGRAPHY: Echocardiography will be considered abnormal if any one of the following parameters will be found during TTE

1. LVEF <50%

2. LVDD grade >1

3. RWMA segments >1

Patients will be assessed in the preoperative/ pre-procedure period, intraoperative /intra- procedure period and postoperative /post-procedure period.

PRO- BNP: Pro BNP is a hormone produced by the heart. The levels increase when there are pressure changes in the heart. These changes are seen in cardiac failure and other cardiac problems.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 75

Inclusion Criteria

Hypertensive patients undergoing an intracranial neurosurgical procedure ASA PS 2 GCS 15/15.

Exclusion Criteria

Pre-existing coronary artery disease (CAD) and active cardiac condition History of chronic liver disease, chronic kidney disease and chronic obstructive airway disease â€ƒ.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The study aimed to evaluate the incidence of cardiovascular abnormality with transthoracic echocardiography (pre operative) in hypertensive patients undergoing neurosurgical procedures.	Baseline , one day after surgery, 7 days after surgery

Secondary Outcome Measures

Name	Time	Method
Incidence of reversibility of cardiovascular abnormality through TTE at discharge or 7 days.	Corelation of cardiovascular abnormality with duration of hypertension and intracranial pathology

Trial Locations

Locations (1): Post Graduate Institute of Medical Education and Research Chandigarh
🇮🇳
Chandigarh, CHANDIGARH, India
Post Graduate Institute of Medical Education and Research Chandigarh
🇮🇳Chandigarh, CHANDIGARH, India
Shiv lal Soni
Principal investigator
9914208550
dr.shivsoni@gmail.com