Non-invasive Measurement of Myocardial Work Using Transthoracic Echocardiography in Critically Ill Patients: the MYOLOAD Study
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Cardiovascular Physiological Phenomena
- Sponsor
- Centre Hospitalier Universitaire de Nice
- Enrollment
- 110
- Locations
- 3
- Primary Endpoint
- Determine the feasibility of echocardiographic measurement
- Status
- Not Yet Recruiting
- Last Updated
- last year
Overview
Brief Summary
Echocardiography is recommended for the hemodynamic management of patients with shock. Recently, a new echocardiographic method has been proposed that provides a non-invasive measurement of myocardial work incorporating different components, namely total myocardial work (GWI), constructive myocardial work (GCW), lost myocardial work (GWW) and effective myocardial work (GWE). Echocardiographic measurement of myocardial work takes into account both myocardial deformation and left ventricular afterload (estimated by measuring systolic blood pressure) and, unlike the measurement of left ventricular ejection fraction and global longitudinal strain, could be less dependent on cardiac load conditions, particularly left ventricular afterload. To date, non-invasive measurement of myocardial work has never been validated in critically ill patients, and no study has assessed the effects of different therapies (fluids administration, administration of norepinephrine) on the different components of myocardial work in patients admitted to intensive care unit.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Indication to fluid administration left to the discretion of the attending physician
- •Indication to norepinephrine administration or increase in norepinephrine dosage left to the discretion of the attending physician.
Exclusion Criteria
- •Patients under protection.
- •Patients with do not ressuscitate order.
- •Patients with severe left-side or right-side valvulopathy.
- •Patients with atrial fibrillation.
- •Patients with ventricular aneuvrysm or severe regional wall motion abnormalities.
- •Patients with a pacemaker.
- •Patients' objections to the collection of their health data.
Outcomes
Primary Outcomes
Determine the feasibility of echocardiographic measurement
Time Frame: through study completion, an average of 1 year
The primary outcome will be assess by evaluating the proportion of patients in whom non-invasive echocardiographic measurement of myocardial work is obtained.
Secondary Outcomes
- measurement of myocardial by cardiac ultrasound during fluid administration(through study completion, an average of 1 year)
- measurement of myocardial by cardiac ultrasound norepinephrine administration(through study completion, an average of 1 year)