Propofol Effects on Mitral Valve Annular Velocity

Study Overview
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Brief Summary
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The purpose of this study is primarily to determine the effects of propofol at different concentration on the mitral valve annulus by using Tissue Doppler Imaging

Detailed Description
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The purpose of this study is to evaluate the effects of different concentration of propofol on patients who are undergoing cardiac surgery. The patients will receive infusion remifentanil 0.5mcg/kg/min with different target-site propofol concentration namely 1.0ng/ml, 2.0ng/ml and 3.0ng/ml. Tissue Doppler Imaging by transesophageal echocardiography will be done to assess the changes in cardiac function.

Official Title
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The Effect of Propofol on Tissue Doppler Imaging of Mitral Valve Annular Velocity During Remifentanil-based Cardiac Anesthesia

Conditions
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Valvular Heart Disease, Coronary Artery Disease

Intervention / Treatment
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* Drug: Propofol 1.0mcg
* Drug: Propofol 2.0mcg
* Drug: Propofol 3.0mcg


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing cardiac surgery Exclusion Criteria: low ejection fraction < 50% on transthoracic echocardiography atrial fibrillation pacemaker pericardial and infiltrative myocardial disease mitral annular calcification, surgical rings, prosthetic mitral valve lateral left ventricular wall motion abnormality oesophageal abnormality history of extensive radiation to the mediastinum upper gastrointestinal bleeding

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 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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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Propofol 1.0mcg<br>Propofol dosage titration, comparison of the effect of different concentration of propofol to the myocardial performances, namely at 1.0mcg/ml using target controlled infusion. | Drug: Propofol 1.0mcg<br>* Propofol dosage titration to achieve effect site concnetration at 1.0 mcg/ml using target controlled infusion.<br>* Other names: Fresofol (2% propofol, Fresinius Kabi);|
| Experimental: Propofol 2.0mcg<br>Propofol dosage titration, comparison of the effect of different concentration of propofol to the myocardial performances, namely at 2.0mcg/ml using target controlled infusion. | Drug: Propofol 2.0mcg<br>* Propofol dosage titration to achieve effect site concnetration at 2.0 mcg/ml using target controlled infusion.<br>* Other names: Fresofol (2% propofol, Fresinius Kabi);|
| Experimental: Propofol 3.0mcg<br>Propofol dosage titration, comparison of the effect of different concentration of propofol to the myocardial performances, namely at 3.0mcg/ml using target controlled infusion. | Drug: Propofol 3.0mcg<br>* Propofol dosage titration to achieve effect site concnetration at 3.0 mcg/ml using target controlled infusion<br>* Other names: Fresofol (2% propofol, Fresinius Kabi);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of systolic mitral valve annular velocity (S') | To examine the effect of Propofol at different effect-site concentration ( 1.0 ng/ml, 2.0 ng/ml and 3.0 ng/ml) on S' (systolic mitral valve annular velocity) during remifentanil-based anesthesia. | 10 min after achieving 3 different propofol concentrations | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Early diastolic mitral valve annular velocity (e') |  | 10 min after achieving 3 different propofol concentrations | 
| late diastolic (atrial contractile) mitral valve annular velocity (a') |  | 10 min after achieving 3 different propofol concentrations | 
| ejection fraction |  | 10 min after achieving 3 different propofol concentrations | 
| phenylephrine infusion rate |  | 10 min after achieving 3 different propofol concentrations |