Clinical trial NCT00907439: Study of the Effect of Inhaled Anesthetics on Diastolic Heart Function Using a Doppler-derived Efficiency Index
Official title: Changes in Diastolic Dysfunction With the Onset of Volatile Anesthesia in Patients Undergoing Coronary Artery Bypass Grafting as Determined by a Load-independent Efficiency Index Derived From the Parameterized Doppler Analysis of Left Ventricular Filling
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Diastolic Dysfunction
Coronary Artery Disease
General Anesthesia
Keywords: Diastole, physiopathology
coronary artery disease
volatile anesthetic
sevoflurane
Lead sponsor: Washington University School of Medicine
Sponsor class: OTHER
First posted: 2009-05-22
Enrollment: 21
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients undergoing non-emergent coronary artery bypass grafting surgery at a tertiary care center

Brief summary: The purpose of this study is to determine the effect of inhaled anesthetic drugs upon diastolic heart function (heart suction and filling performance) in patients who are undergoing coronary bypass surgery.

Detailed description: Diastolic heart dysfunction is a significant cause of cardiovascular morbidity and is the cause of symptomatic heart failure in approximately one half of patients who are admitted to hospitals with heart failure symptoms. However, diastolic heart function remains difficult to measure objectively without cardiac catheterization. Diastolic heart dysfunction is also common among patients undergoing coronary bypass grafting (CABG) surgery. Despite the ubiquitous use of inhaled volatile drugs to maintain anesthesia in these patients, their effects upon diastolic heart function remain unclear.

Eligibility criteria: Inclusion Criteria:

* Non-emergent coronary bypass grafting surgery
* Left ventricular ejection fraction of 40% or greater

Exclusion Criteria:

* Myocardial infarction within 4 weeks
* Greater than mild cardiac valvular pathology
* Body mass index greater than 35
* Cardiac dysrhythmias or pacemaker therapy
* Left bundle branch block
* Uncontrolled gastroesophageal reflux disease

Primary outcomes:
measure: Diastolic efficiency index (derived from the parameterized analysis of transmitral early filling Doppler using the paradigm of the ventricle as a damped harmonic oscillator)
timeFrame: Following induction of volatile anesthesia
Secondary outcomes:
measure: Diastolic efficiency index (derived from the parameterized analysis of transmitral early filling Doppler using the paradigm of the ventricle as a damped harmonic oscillator)
timeFrame: Following the onset of controlled ventilation
Other outcomes:
Locations:
city: St Louis
country: United States
facility: Barnes-Jewish Hospital
state: Missouri
Study officials:
affiliation: Washington University School of Medicine, Department of Anesthesiology
name: Troy S Wildes, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Shmuylovich L, Kovacs SJ. Load-independent index of diastolic filling: model-based derivation with in vivo validation in control and diastolic dysfunction subjects. J Appl Physiol (1985). 2006 Jul;101(1):92-101. doi: 10.1152/japplphysiol.01305.2005. Epub 2006 Mar 30.
citation: Boskovski MT, Shmuylovich L, Kovacs SJ. Transmitral flow velocity-contour variation after premature ventricular contractions: a novel test of the load-independent index of diastolic filling. Ultrasound Med Biol. 2008 Dec;34(12):1901-8. doi: 10.1016/j.ultrasmedbio.2008.05.002. Epub 2008 Aug 9.