Assessment of Diastolic Function in High Risk Patients Undergoing Major Vascular Surgery

Study Overview
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Brief Summary
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Patients scheduled for Thoracic Endovascular Aortic Repair (TEVAR) surgery will have transthoracic echocardiography evaluation of left ventricle diastolic function during the perioperative period.

Detailed Description
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Patients undergoing TEVAR surgery are a high risk group of developing perioperative cardiovascular complications. Left ventricle diastolic dysfunction is common in this group of patients because of the prevalence of risk factors: > 60 years old, hypertension, smoking history and diabetes. Because of many predisposing factors that occur during the surgery: stress respond, fluid shifts, anaesthesia and mechanical ventilation. Deterioration of the diastolic function is likely to occur in perioperative period In this study, the investigators will evaluate change in left ventricle diastolic function as a marker for early detection of a myocardial failure in patients scheduled for an elective TEVAR surgery. The examination will be performed preoperatively, shortly after the surgery and 24 hours after the surgery. Aim: The aim of the study is to evaluate the diastolic function of left ventricle in perioperative period after high risk surgery. This may provide a valuable information in preoperative risk stratification and postoperative therapy guidance.

Official Title
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Assessment of Left Ventricle Diastolic Function in High Risk Patients Undergoing Major Vascular Surgery as an Early Indicator of Cardiac Failure. Observational Study

Conditions
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Diastolic Dysfunction, Heart Failure, Aneurysm Aortic

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: scheduled TEVAR >60 years old Exclusion Criteria: Atrial fibrillation or other non-sinus rhythms Atrioventricular blocks Heart rate change more than 25% postoperatively Not adequate transthoracic view Postoperative shock Sepsis

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in left ventricle diastolic function in time | Echocardiographic assessment of change in left ventricle diastolic function repeated in time intervals: Baseline before the surgery, 2 and 24 hours after the surgery | Baseline, 2 hours and 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in biochemistry markers: troponins | Assessment of change in level of troponins. Baseline before the surgery, 2 and 24 hours after the surgery | Baseline, 2 hours and 24 hours | 
| Change in biochemistry markers: brain natriuretic peptide | Assessment of change in level of brain natriuretic peptide. Baseline before the surgery, 2 and 24 hours after the surgery | Baseline, 2 hours and 24 hours | 
| Change in left ventricle systolic function | Echocardiographic assessment of change in left ventricle systolic function repeated in time intervals: Baseline before the surgery, 2 and 24 hours after the surgery | Baseline, 2 hours and 24 hours | 
| Hemodynamic parameters: Heart rate | Heart rate during echocardiography evaluation. | Baseline, 2 hours and 24 hours | 
| Hemodynamic parameters: Systolic and diastolic pressure | Systolic and diastolic pressure measurements during echocardiography evaluation. Record vasopressors requirement. | Baseline, 2 hours and 24 hours | 
| Fluid balance | Monitoring of diuresis hourly, fluid losses and fluids intake | 72 hours | 
| Kidney function | Monitoring of glomerular filtration rate and requirement for a dialysis daily | 72 hours | 
| Length of stay in hospital | Documentation of length of stay in hospital since the surgery | up to 14 days | 
| Mortality | Documentation of in-hospital mortality and 30 days mortality | up to 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diastolic Dysfunction, Anesthesia, Preoperative assessment, Postoperative care, TEVAR