Perioperative myocardial injury (MINS) and coronary microvascular dysfunction in cMRI
- Conditions
- Perioperative myocardial injury
- Registration Number
- DRKS00034148
- Lead Sponsor
- niversitätsmedizin Göttingen
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Pending
- Sex
- All
- Target Recruitment
- 180
Patients undergoing orthopaedic trauma surgery with medium to high surgical risk
o Operations on the spine, hip joint replacement
At least 1 risk factor for CMD
o CMD risk factors: female gender, advanced age, arterial hypertension, obesity p.m., hyperlipidaemia, diabetes mellitus, chronic renal insufficiency, smoking. renal insufficiency, nicotine consumption.
- Age <18 years
- Pregnancy and breastfeeding
- Operations on patients with congenital heart defects
- Operations on patients with long-term corticosteroid therapy
- Patients with calcium antagonists and/or nitrates in prior medication
- Emergency operations
- Patients with cardiac devices and post heart valve replacement (regardless of MRI compatibility)
- Patients with Raynaud's syndrome and/or PAD and/or vasculitis
- Exclusion criteria due to contraindications for adenosine
o Hypersensitivity to adenosine
o AV block II. or III. degree (except for patients with a functioning pacemaker)
o sick sinus syndrome
o Atrial fibrillation or flutter; patients who have atrial fibrillation or flutter and an additional (accessory) conduction pathway between the atrium and ventricle may exhibit accelerated conduction and thus develop an increased ventricular rate
o Chronic obstructive pulmonary disease with bronchospasm (e.g. bronchial asthma)
o prolonged QT interval, regardless of whether this is congenital, induced by a substance or occurs as a result of a metabolic event, as torsade de pointes can be triggered
o severe hypotension
o decompensated heart failure
o concomitant use with dipyridamole (due to up to 4-fold increase in the effect of adenosine)
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Myocardial damage defined by a significant increase in toponin I within 72h postoperatively.
- Secondary Outcome Measures
Name Time Method ew or increasing diastolic dysfunction is screened for by means of TTE examination preoperatively and in the event of troponin I elevation. In addition, the occurrence of perioperative major adverse cardiovascular events (MACE; composite endpoint of acute myocardial infarction, acute heart failure, life-threatening cardiac arrhythmias and cardiovascular death) is clinically monitored.