Effect of Desflurane on Left Ventricular Function in Remifentanil-based Anesthesia for Cardiac Surgery: Tissue Doppler Imaging of Mitral Valve Annular Velocity
试验速览
- 阶段
- 不适用
- 入组人数
- 14
- 试验地点
- 1
- 主要终点
- Peak systolic mitral annular velocity (S')
研究概览
简要总结
The purpose of this study is to determine desflurane's dose-dependent effect on left ventricular (LV) function in cardiac surgery. The change of tissue Doppler imaging (TDI) of lateral mitral valve annular velocity at three different desflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (TEE) in cardiac surgery patients
详细描述
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 ling-axix function , efficacy of diastolic TDI profile, including early early relaxation (E') and atrial contraction (A') and has been suggested to be useful in predicting the postoperative clinical outcomes and the impact of isoflurane on LV diastolic function.
Desflurane is widely used in cardiac surgery patients due to its beneficial effects , but many studies have shown that desflurane reduces myocardial contractility in a dose-dependent manner, and compromises left ventricular( LV) function We hypothesized that desflurane , 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 mitral annular velocity.
So we planned to study the changes in TDI profiles of lateral mitral annular velocity at the clinical desflurane dosage during remifentanil based anesthesia for cardiac surgery
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
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
- 是
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
Desflurane increment
increment of desflurane 0.5-1.5 MAC in remifentanil anesthesia for cardiac surgery
干预措施: increment of desflurane (Drug)
结局指标
主要结局
Peak systolic mitral annular velocity (S')
时间窗: after 10 min exposure to desflurane 0.5, 1.0 and 1.5 MAC
Peak systolic mitral annular velocity (S') using tissue Doppler imaging 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 desflurane, 0.5 MAC, 1.0 MAC and 1.5 MAC (T1, T2 and T3, respectively)
次要结局
- diastolic mital annular veocities (E' and A'), ejection fraction (EF), Bispectral index(after 10 min exposure to desflurane 0.5, 1.0 and1.5 MAC)
研究者
Tae-Yop Kim, MD PhD
Professor of Anesthesiology
Konkuk University Medical Center