AzTrials
AzTrials

Coronary SurgeryNCT03922178

Evaluation of Hemodynamic Changes of the Left Ventricle Following the Use of Extracorporeal Circulation

A study testing Pressure/Volume Combination Catheter, Transthoracic echocardiography and Transesophageal echocardiogram in people with Coronary Surgery, run by Pierre Wauthy at 1 site in Belgium.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The interpretation of perioperative measures of cardiac function during cardiac surgery is complicated. In particular, the evaluation of the diastolic compliance of the left ventricle. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Coronary Surgery
What is being tested?
Pressure/Volume Combination Catheter, Transthoracic echocardiography and Transesophageal echocardiogram
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
9 participants
Where
1 siteBelgium
Study dates
13 Nov 2018to 16 Jan 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient of the CHU Brugmann Hospital receiving elective coronary surgery.
  • Patient in sinusal rhythm before the operation and during the collection of hemodynamic data.
  • Patients with conserved left ventricular function (based on left ventricular ejection fraction assessed by preoperative echocardiography and superior to 50%)

Who cannot join

  • Hypertrophic cardiomyopathy (diastolic septal thickness> 15 mm)
  • Heart failure with left ventricular ejection fraction <50%
  • Presence of cardiac valvulopathy, concerning both right and left atrio-ventricular and ventriculo-arterial valves
  • Presence of valvular prosthesis
  • Congenital heart disease
  • Pregnancy
  • Participation to another clinical study

Trial locations and contacts

1 site in 1 country.

Belgium1 site
  • CHU Brugmann

    Brussels, 1020

Other trials in Belgium

About this study

The interpretation of perioperative measures of cardiac function during cardiac surgery is complicated. In particular, the evaluation of the diastolic compliance of the left ventricle. In addition, they are subject to variations induced by post-charge changes caused by the anesthesia, extracorporeal circulation (ECC) and the surgical procedure itself.

Left ventricular failure is frequently measured by alteration of LV contractile properties, and very rarely by alteration of LV compliance. However, both contractility (systolic) and relaxation (diastolic) parameters are important for the left ventricle to perform its function adequately. Left ventricular failure after cardiac surgery with extracorporeal circulation and cardiac arrest under cardioplegia protection is an important and frequently reported complication. The investigator's objectives are to characterize the diastolic hemodynamic mechanisms of this left ventricular failure and to identify predictors of this failure in the postoperative period.

Read more

The quantification of the systolic and diastolic functions of the left ventricle by ventricular pressure-volume curves is the technique of reference today, because it allows to determine parameters that are independent of the pre- and post-load conditions. Previous studies using the conductance catheter for the purpose of estimating left ventricular function perioperatively are rare and report conflicting results. In addition, they were mainly intended to measure the systolic function of the left ventricle. Only one reported the diastolic relaxation parameters evaluated by a conductance catheter. This study showed immediately after withdrawal of the extracorporeal circulation a significant alteration of the diastolic relaxation of the left ventricle, but was not interested in its early (kinetic) evolution peroperatively.

The investigator's experience shows that, in the quarter-hour following the weaning of the extracorporeal circulation, a decrease in filling pressures of the left ventricle concomitant with an increase in cardiac output is objectified. These observations are consistent with a significant improvement in left ventricle compliance, but have never been reported.

The objectives of this study are:

  • To characterize the left ventricular diastolic failure after withdrawal of the extracorporeal circulation in coronary surgery.
  • To identify the kinetics of this early diastolic failure after withdrawal of the extracorporeal circulation.
Being tested
Pressure/Volume Combination Catheter, Transthoracic echocardiography, Transesophageal echocardiogram

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pressure/Volume Combination CatheterDevice

    Hemodynamic data routinely collected and data collected by means of the placement of a Pressure/Volume Combination Catheter (Pressure/Volume Combination Catheter,Leycom,The Netherlands) will be collected simultaneously. The catheter will be placed and held in place as long as the patient is in a position to be assisted by extracorporeal circulation. This means that the placement of the catheter will follow the heparinization of the patient and the placement of the cannulas necessary for the realization of extracorporal circulation. It will be removed from the left ventricular cavity before removal of extra-corporal cannulas.

  • Transthoracic echocardiographyDevice

    A complete transthoracic echocardiography will be performed the day before the surgical procedure, as per standard of care. It will establish the presence of the inclusion and exclusion criteria and evaluate the contractile function of the left ventricle. This will be done using a Philips IE33 echocardiograph (Koninklijke Philips Electronics N.V., Netherlands).

  • Transesophageal echocardiogramDevice

    A transesophageal echocardiogram will be performed during the cardiac surgery, as per standard of care, using an Acuson Sequoia system (Siemens AG, Germany). It will facilitate the placement of the pressure/volume combination catheter and collect echographic data.

Study groups in NCT03922178
Study groupRoleWhat they receive
Elective coronary surgeryExperimentalThe study will be conducted at the CHU Brugmann Hospital, with collaboration between cardiac surgery and anesthesiology wards. Subjects referred for elective coronary surgery will be prospectively included during the length of the study.
Receives: Device: Pressure/Volume Combination Catheter; Device: Transthoracic echocardiography; Device: Transesophageal echocardiogram

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Tele-systolic pressure of the left ventricle

    Pressure within the left ventricle after the atrial contraction, at the beginning of the ventricular contraction.

    Measured: Baseline (before extracorporeal circulation is switched on)

  2. Tele-systolic pressure of the left ventricle

    Pressure within the left ventricle after the atrial contraction, at the beginning of the ventricular contraction.

    Measured: 1 minute after extracorporeal circulation is switched on

  3. Tele-systolic pressure of the left ventricle

    Pressure within the left ventricle after the atrial contraction, at the beginning of the ventricular contraction.

    Measured: 1 minute after extracorporeal circulation is stopped

  4. Tele-systolic pressure of the left ventricle

    Pressure within the left ventricle after the atrial contraction, at the beginning of the ventricular contraction.

    Measured: 10 minutes after extracorporeal circulation is stopped

  5. Tele-systolic pressure of the left ventricle

    Pressure within the left ventricle after the atrial contraction, at the beginning of the ventricular contraction.

    Measured: 20 minutes after extracorporeal circulation is stopped

  6. Diastolic pressure of the left ventricle

    The pressure within the left ventricle following the completion of diastolic filling, just prior to systole.

    Measured: Baseline (before extracorporeal circulation is switched on)

  7. Diastolic pressure of the left ventricle

    The pressure within the left ventricle following the completion of diastolic filling, just prior to systole.

    Measured: 1 minute after extracorporeal circulation is switched on

  8. Diastolic pressure of the left ventricle

    The pressure within the left ventricle following the completion of diastolic filling, just prior to systole.

    Measured: 1 minute after extracorporeal circulation is stopped

  9. Diastolic pressure of the left ventricle

    The pressure within the left ventricle following the completion of diastolic filling, just prior to systole.

    Measured: 10 minutes after extracorporeal circulation is stopped

  10. Diastolic pressure of the left ventricle

    The pressure within the left ventricle following the completion of diastolic filling, just prior to systole.

    Measured: 20 minutes after extracorporeal circulation is stopped

  11. Tele-systolic volume of the left ventricle

    At the end of systole, the ventricle contains a quantity of blood called 'telesystolic volume'.

    Measured: Baseline

  12. Tele-systolic volume of the left ventricle

    At the end of systole, the ventricle contains a quantity of blood called 'telesystolic volume'.

    Measured: 1 minute after extracorporeal circulation is switched on

  13. Tele-systolic volume of the left ventricle

    At the end of systole, the ventricle contains a quantity of blood called 'telesystolic volume'.

    Measured: 1 minute after extracorporeal circulation is stopped

  14. Tele-systolic volume of the left ventricle

    At the end of systole, the ventricle contains a quantity of blood called 'telesystolic volume'.

    Measured: 10 minutes after extracorporeal circulation is stopped

  15. Tele-systolic volume of the left ventricle

    At the end of systole, the ventricle contains a quantity of blood called 'telesystolic volume'.

    Measured: 20 minutes after extracorporeal circulation is stopped

  16. Diastolic volume of the left ventricle

    At the end of diastole, the ventricle contains a quantity of blood called end-diastolic volume.

    Measured: Baseline

  17. Diastolic volume of the left ventricle

    At the end of diastole, the ventricle contains a quantity of blood called end-diastolic volume.

    Measured: 1 minute after extracorporeal circulation is switched on

  18. Diastolic volume of the left ventricle

    At the end of diastole, the ventricle contains a quantity of blood called end-diastolic volume.

    Measured: 1 minute after extracorporeal circulation is stopped

  19. Diastolic volume of the left ventricle

    At the end of diastole, the ventricle contains a quantity of blood called end-diastolic volume.

    Measured: 10 minutes after extracorporeal circulation is stopped

  20. Diastolic volume of the left ventricle

    At the end of diastole, the ventricle contains a quantity of blood called end-diastolic volume.

    Measured: 20 minutes after extracorporeal circulation is stopped

  21. Ejection volume of the left ventricle

    The ejection volume is the difference between systolic and diastolic volume. It represents the amount of blood ejected at each contraction by the ventricle.

    Measured: Baseline

  22. Ejection volume of the left ventricle

    The ejection volume is the difference between systolic and diastolic volume. It represents the amount of blood ejected at each contraction by the ventricle.

    Measured: 1 minute after extracorporeal circulation is switched on

  23. Ejection volume of the left ventricle

    The ejection volume is the difference between systolic and diastolic volume. It represents the amount of blood ejected at each contraction by the ventricle.

    Measured: 1 minute after extracorporeal circulation is stopped

  24. Ejection volume of the left ventricle

    The ejection volume is the difference between systolic and diastolic volume. It represents the amount of blood ejected at each contraction by the ventricle.

    Measured: 10 minutes after extracorporeal circulation is stopped

  25. Ejection volume of the left ventricle

    The ejection volume is the difference between systolic and diastolic volume. It represents the amount of blood ejected at each contraction by the ventricle.

    Measured: 20 minutes after extracorporeal circulation is stopped

  26. Contractility index of the left ventricle

    Computed by the following formula: (dP/dt max)/P

    Measured: Baseline

  27. Contractility index of the left ventricle

    Computed by the following formula: (dP/dt max)/P

    Measured: 1 minute after extracorporeal circulation is switched on

  28. Contractility index of the left ventricle

    Computed by the following formula: (dP/dt max)/P

    Measured: 1 minute after extracorporeal circulation is stopped

  29. Contractility index of the left ventricle

    Computed by the following formula: (dP/dt max)/P

    Measured: 10 minutes after extracorporeal circulation is stopped

  30. Contractility index of the left ventricle

    Computed by the following formula: (dP/dt max)/P

    Measured: 20 minutes after extracorporeal circulation is stopped

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Apr 2019
  2. Study start13 Nov 2018
  3. Primary completion16 Jan 2020
  4. Study completion16 Jan 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
9 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03922178
Sponsor's protocol ID
CHUB-Leclercq
Status last verified
Jan 2020
First submitted
17 Apr 2019
Last updated
18 Jan 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Pressure/Volume Combination Catheter, Transthoracic echocardiography and Transesophageal echocardiogram in people with Coronary Surgery, run by Pierre Wauthy at 1 site in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Tele-systolic pressure of the left ventricle (time frame: Baseline (before extracorporeal circulation is switched on)). The study lists 30 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jan 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in