Heart ChambersCM-TTE-TEENCT06715371
Comparing Cardiac Chamber Measurements: TTE vs. TEE Under Anesthesia
An observational study of Heart Chambers, run by Sunnybrook Health Sciences Centre at 1 site in Canada.
Trial summary
This study aims to compare two common ultrasound techniques used during heart surgery: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is performed by placing an ultrasound probe on the chest, while TEE involves inserting a probe into the esophagus, which provides closer and… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Heart Chambers
- What is being tested?
- Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)
- How many people
- 114 participants
- Where
- 1 siteCanada
- Study dates
- 27 Jan 2025to Jun 2026
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adult patients undergoing elective cardiac surgery, specifically coronary revascularization procedures.
Who may be able to join
- Age ≥ 18, able to provide informed consent.
- Patients scheduled for coronary revascularization cardiac surgery under general anesthesia.
- With normal left ventricular (LV) systolic function, defined by an ejection fraction of 50% or more, and normal right ventricular (RV) systolic function.
- Requiring intraoperative echocardiographic assessment.
Who cannot join
- Patients with contraindications to either transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE).
- History of poor-quality echocardiography data that preclude accurate assessment.
- Undergoing emergency cardiac surgery.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site, 1 recruiting
- Recruiting
Sunnybrook Health Sciences Centre
Toronto, Ontario, M4N 3M5
Lilia Kaustov, PhD, 416-480-6100 ext. 89607, lilia.kaustov@sunnybrook.ca
About this study
Official title: Reassessing Normative Cardiac Chamber Measurements: A Comparative Study of TTE and TEE Under General Anesthesia.
This study aims to compare two common ultrasound techniques used during heart surgery: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is performed by placing an ultrasound probe on the chest, while TEE involves inserting a probe into the esophagus, which provides closer and clearer images of the heart. Both methods are part of routine care for patients undergoing heart surgery.
The goal of this study is to assess how well the measurements from TTE and TEE agree in evaluating heart chamber dimensions during surgery and to investigate how factors such as anesthesia, breathing techniques affect these measurements.
Read more
This research involves 114 adult patients scheduled for heart surgery at Sunnybrook Health Sciences Centre. Participants will have TTE performed before and after surgery, and TEE will be conducted during surgery. All procedures are part of the usual standard of care.
By comparing these imaging techniques, the study seeks to provide more accurate and up-to-date guidelines for cardiac measurements, ensuring better care for patients during heart surgery.
Read the detailed description
This observational study compares transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in measuring cardiac chamber dimensions in adult patients undergoing cardiac surgery. While both techniques are integral to clinical care, TEE is typically used intraoperatively for its superior image quality, and TTE is performed preoperatively as a non-invasive diagnostic tool. However, differences in measurement values between TTE and TEE, particularly under the physiological changes induced by general anesthesia and positive end-expiratory pressure (PEEP), remain poorly understood. This study seeks to address this gap and update normative cardiac measurement values.
Study Design: A prospective observational study enrolling patients scheduled for coronary revascularization surgery at Sunnybrook Health Sciences Centre (n=114). All imaging procedures are part of routine clinical care.
Primary Objective: To evaluate the agreement between preoperative TTE and intraoperative TEE measurements of cardiac chamber dimensions.
Secondary Objectives:
- To explore how physiological changes from general anesthesia and PEEP impact the correlation between TTE and TEE measurements.
- To analyze how pre-existing cardiac conditions (e.g., hypertension, diabetes, atrial fibrillation) affect the agreement between these modalities.
- Conditions
- Heart Chambers
- Being tested
- Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)
- Keywords
- Cardiac Imaging, Cardiac Chamber Dimensions, General Anesthesia, Cardiac Surgery, Imaging Agreement, Diagnostic Accuracy, Perioperative Care, Echocardiography
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)Diagnostic test
Also called Transthoracic Echocardiography (TTE), Transesophageal Echocardiography (TEE)
Transthoracic echocardiography (TTE) is a non-invasive imaging technique performed by placing an ultrasound transducer on the chest to obtain detailed heart images. TTE is conducted preoperatively on awake patients within two weeks prior to cardiac surgery, following ASE chamber quantification guidelines.
Transesophageal echocardiography (TEE) is an invasive imaging technique where an ultrasound transducer is placed in the esophagus, providing closer and clearer images of the heart. TEE is performed intraoperatively under general anesthesia as part of routine care.
| Study group | Role | What they receive |
|---|---|---|
| Cardiac Surgery Patients | Patients undergoing cardiac surgery (eg., coronary revascularization) at Sunnybrook Health Sciences Centre. Receives: Diagnostic Test: Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Correlation between preoperative TTE and intraoperative TEE measurements
The correlation between preoperative transthoracic echocardiography (TTE) and intraoperative transesophageal echocardiography (TEE) measurements of cardiac chamber dimensions, including left ventricular internal dimensions, left atrial volume, and right atrial dimensions.
Measured: Within 2 weeks prior to surgery and during surgery
Secondary outcomes (3)
Impact of general anesthesia on correlation between TTE and TEE.
Impact of physiological changes induced by general anesthesia on the correlation between TTE and TEE measurements.
Measured: Within 2 weeks prior to surgery and during surgery
Impact of PEEP on correlation between TTE and TEE
Impact of physiological changes induced by PEEP on the correlation between TTE and TEE measurements.
Measured: Within 2 weeks prior to surgery and during surgery
Impact of cardiac conditions on correlation between TTE and TEE.
Impact of cardiac conditions (e.g., COPD, hypertension, history of atrial fibrillation) on the correlation between TTE and TEE measurements.
Measured: Within 2 weeks prior to surgery and during surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Dec 2024
- Study start27 Jan 2025
- Primary completion2 Mar 2026 (estimated)
- Study completionJun 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Heart ChambersStudies of the same condition, open and under way.
- More trials run by Sunnybrook Health Sciences CentreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 114 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sunnybrook Health Sciences Centre
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jacobo Moreno Garijo, MD, PhD, Principal investigator, Sunnybrook Health Sciences Centre
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06715371
- Sponsor's protocol ID
- 6347
- Acronym
- CM-TTE-TEE
- Status last verified
- Nov 2024
- First submitted
- 28 Nov 2024
- Last updated
- 3 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified participant-level data will be made available upon reasonable request to study PI following publication of full trial results.
Publications
Kabirdas D, Scridon C, Brenes JC, Hernandez AV, Novaro GM, Asher CR. Accuracy of transthoracic echocardiography for the measurement of the ascending aorta: comparison with transesophageal echocardiography. Clin Cardiol. 2010 Aug;33(8):502-7. doi: 10.1002/clc.20807.
PubMed 20734448Singh H, Jain AC, Bhumbla DK, Failinger C. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. Echocardiography. 2005 Nov;22(10):789-96. doi: 10.1111/j.1540-8175.2005.00128.x.
PubMed 16343160Shiran A, Adawi S, Ganaeem M, Asmer E. Accuracy and reproducibility of left ventricular outflow tract diameter measurement using transthoracic when compared with transesophageal echocardiography in systole and diastole. Eur J Echocardiogr. 2009 Mar;10(2):319-24. doi: 10.1093/ejechocard/jen254. Epub 2008 Oct 2.
PubMed 18835821Block M, Hourigan L, Bellows WH, Reeves J 3rd, Romson JL, Tran M, Pastor D, Schiller NB, Leung JM. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. J Am Soc Echocardiogr. 2002 Feb;15(2):143-9. doi: 10.1067/mje.2002.121399.
PubMed 11836489Assanangkornchai N, Villeneuve V, McDonald S, Magder S, Shum Tim D, Buithieu J, Hatzakorzian R. Interchangeability of transthoracic and transesophageal echocardiographic right heart measurements in the perioperative setting and correlation with hemodynamic parameters. Int J Cardiovasc Imaging. 2023 Mar;39(3):555-563. doi: 10.1007/s10554-022-02754-1. Epub 2022 Nov 18.
PubMed 36399180Skarvan K, Lambert A, Filipovic M, Seeberger M. Reference values for left ventricular function in subjects under general anaesthesia and controlled ventilation assessed by two-dimensional transoesophageal echocardiography. Eur J Anaesthesiol. 2001 Nov;18(11):713-22. doi: 10.1046/j.1365-2346.2001.00915.x.
PubMed 11580777Cohen GI, White M, Sochowski RA, Klein AL, Bridge PD, Stewart WJ, Chan KL. Reference values for normal adult transesophageal echocardiographic measurements. J Am Soc Echocardiogr. 1995 May-Jun;8(3):221-30. doi: 10.1016/s0894-7317(05)80031-8.
PubMed 7640014Teran F, Prats MI, Nelson BP, Kessler R, Blaivas M, Peberdy MA, Shillcutt SK, Arntfield RT, Bahner D. Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. J Am Coll Cardiol. 2020 Aug 11;76(6):745-754. doi: 10.1016/j.jacc.2020.05.074.
PubMed 32762909Giron-Arango L, D'Empaire PP. Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient? Curr Anesthesiol Rep. 2022;12(2):210-216. doi: 10.1007/s40140-022-00526-0. Epub 2022 Mar 19.
PubMed 35340714
Study at a glance
From the registry record, last updated by the sponsor on 3 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Reassessing Normative Cardiac Chamber Measurements: A Comparative Study of TTE and TEE Under General Anesthesia.
- ClinicalTrials.gov ID
- NCT06715371
- Acronym / sponsor ID
- CM-TTE-TEE / 6347
- Conditions
- Heart Chambers
- Keywords
- Cardiac Imaging, Cardiac Chamber Dimensions, General Anesthesia, Cardiac Surgery, Imaging Agreement, Diagnostic Accuracy, Perioperative Care, Echocardiography
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 114 participants (estimated)
- Lead sponsor
- Sunnybrook Health Sciences CentreUniversity, hospital or other
- Study start
- 27 Jan 2025 (actual)
- Primary completion
- 2 Mar 2026 (estimated)
- Study completion
- Jun 2026 (estimated)
- First posted
- 4 Dec 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to compare two common ultrasound techniques used during heart surgery: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is performed by placing an ultrasound probe on the chest, while TEE involves inserting a probe into the esophagus, which provides closer and clearer images of the heart. Both methods are part of routine care for patients undergoing heart surgery.
The goal of this study is to assess how well the measurements from TTE and TEE agree in evaluating heart chamber dimensions during surgery and to investigate how factors such as anesthesia, breathing techniques affect these measurements.
This research involves 114 adult patients scheduled for heart surgery at Sunnybrook Health Sciences Centre. Participants will have TTE performed before and after surgery, and TEE will be conducted during surgery. All procedures are part of the usual standard of care.
By comparing these imaging techniques, the study seeks to provide more accurate and up-to-date guidelines for cardiac measurements, ensuring better care for patients during heart surgery.
Detailed description
This observational study compares transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in measuring cardiac chamber dimensions in adult patients undergoing cardiac surgery. While both techniques are integral to clinical care, TEE is typically used intraoperatively for its superior image quality, and TTE is performed preoperatively as a non-invasive diagnostic tool. However, differences in measurement values between TTE and TEE, particularly under the physiological changes induced by general anesthesia and positive end-expiratory pressure (PEEP), remain poorly understood. This study seeks to address this gap and update normative cardiac measurement values.
Study Design: A prospective observational study enrolling patients scheduled for coronary revascularization surgery at Sunnybrook Health Sciences Centre (n=114). All imaging procedures are part of routine clinical care.
Primary Objective: To evaluate the agreement between preoperative TTE and intraoperative TEE measurements of cardiac chamber dimensions.
Secondary Objectives:
- To explore how physiological changes from general anesthesia and PEEP impact the correlation between TTE and TEE measurements.
- To analyze how pre-existing cardiac conditions (e.g., hypertension, diabetes, atrial fibrillation) affect the agreement between these modalities.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Cardiac Surgery Patients | – | Diagnostic Test: Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)Patients undergoing cardiac surgery (eg., coronary revascularization) at Sunnybrook Health Sciences Centre. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adult patients undergoing elective cardiac surgery, specifically coronary revascularization procedures.
Key inclusion criteria (4 listed)
- Age ≥ 18, able to provide informed consent.
- Patients scheduled for coronary revascularization cardiac surgery under general anesthesia.
- With normal left ventricular (LV) systolic function, defined by an ejection fraction of 50% or more, and normal right ventricular (RV) systolic function.
- Requiring intraoperative echocardiographic assessment.
Key exclusion criteria (3 listed)
- Patients with contraindications to either transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE).
- History of poor-quality echocardiography data that preclude accurate assessment.
- Undergoing emergency cardiac surgery.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)Also: Transthoracic Echocardiography (TTE), Transesophageal Echocardiography (TEE)Transthoracic echocardiography (TTE) is a non-invasive imaging technique performed by placing an ultrasound transducer on the chest to obtain detailed heart images. TTE is conducted preoperatively on awake patients within two weeks prior to cardiac surgery, following ASE chamber quantification guidelines. Transesophageal echocardiography (TEE) is an invasive imaging technique where an ultrasound transducer is placed in the esophagus, providing closer and clearer images of the heart. TEE is performed intraoperatively under general anesthesia as part of routine care. | Diagnostic test | Cardiac Surgery Patients |
Primary outcome
Correlation between preoperative TTE and intraoperative TEE measurements
Time frame: Within 2 weeks prior to surgery and during surgery
The correlation between preoperative transthoracic echocardiography (TTE) and intraoperative transesophageal echocardiography (TEE) measurements of cardiac chamber dimensions, including left ventricular internal dimensions, left atrial volume, and right atrial dimensions.
3 secondary outcomes
Impact of general anesthesia on correlation between TTE and TEE.
Time frame: Within 2 weeks prior to surgery and during surgery
Impact of PEEP on correlation between TTE and TEE
Time frame: Within 2 weeks prior to surgery and during surgery
Impact of cardiac conditions on correlation between TTE and TEE.
Time frame: Within 2 weeks prior to surgery and during surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jul 2025.
- Background: PubMed 20734448Kabirdas D, Scridon C, Brenes JC, Hernandez AV, Novaro GM, Asher CR. Accuracy of transthoracic echocardiography for the measurement of the ascending aorta: comparison with transesophageal echocardiography. Clin Cardiol. 2010 Aug;33(8):502-7. doi: 10.1002/clc.20807.
- Background: PubMed 16343160Singh H, Jain AC, Bhumbla DK, Failinger C. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. Echocardiography. 2005 Nov;22(10):789-96. doi: 10.1111/j.1540-8175.2005.00128.x.
- Background: PubMed 18835821Shiran A, Adawi S, Ganaeem M, Asmer E. Accuracy and reproducibility of left ventricular outflow tract diameter measurement using transthoracic when compared with transesophageal echocardiography in systole and diastole. Eur J Echocardiogr. 2009 Mar;10(2):319-24. doi: 10.1093/ejechocard/jen254. Epub 2008 Oct 2.
- Background: PubMed 11836489Block M, Hourigan L, Bellows WH, Reeves J 3rd, Romson JL, Tran M, Pastor D, Schiller NB, Leung JM. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. J Am Soc Echocardiogr. 2002 Feb;15(2):143-9. doi: 10.1067/mje.2002.121399.
- Background: PubMed 36399180Assanangkornchai N, Villeneuve V, McDonald S, Magder S, Shum Tim D, Buithieu J, Hatzakorzian R. Interchangeability of transthoracic and transesophageal echocardiographic right heart measurements in the perioperative setting and correlation with hemodynamic parameters. Int J Cardiovasc Imaging. 2023 Mar;39(3):555-563. doi: 10.1007/s10554-022-02754-1. Epub 2022 Nov 18.
- Background: PubMed 11580777Skarvan K, Lambert A, Filipovic M, Seeberger M. Reference values for left ventricular function in subjects under general anaesthesia and controlled ventilation assessed by two-dimensional transoesophageal echocardiography. Eur J Anaesthesiol. 2001 Nov;18(11):713-22. doi: 10.1046/j.1365-2346.2001.00915.x.
- Background: PubMed 7640014Cohen GI, White M, Sochowski RA, Klein AL, Bridge PD, Stewart WJ, Chan KL. Reference values for normal adult transesophageal echocardiographic measurements. J Am Soc Echocardiogr. 1995 May-Jun;8(3):221-30. doi: 10.1016/s0894-7317(05)80031-8.
- Background: PubMed 32762909Teran F, Prats MI, Nelson BP, Kessler R, Blaivas M, Peberdy MA, Shillcutt SK, Arntfield RT, Bahner D. Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. J Am Coll Cardiol. 2020 Aug 11;76(6):745-754. doi: 10.1016/j.jacc.2020.05.074.
- Background: PubMed 35340714Giron-Arango L, D'Empaire PP. Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient? Curr Anesthesiol Rep. 2022;12(2):210-216. doi: 10.1007/s40140-022-00526-0. Epub 2022 Mar 19.
- Individual participant dataSharing planned: Yes. De-identified participant-level data will be made available upon reasonable request to study PI following publication of full trial results.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jacobo Moreno Garijo, MD, PhD principal investigator
Sunnybrook Health Sciences Centre
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Heart Chambers, run by Sunnybrook Health Sciences Centre at 1 site in Canada.
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 4 inclusion and 3 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: looking for participants now, as of the sponsor's last update on 3 Jul 2025. 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 Canada. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jacobo Moreno Garijo, MD, PhD (416-480-4864, jacobo.morenogarijo@sunnybrook.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Correlation between preoperative TTE and intraoperative TEE measurements (time frame: Within 2 weeks prior to surgery and during surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06715371, which also lists 9 linked publications.
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 3 Jul 2025.