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| Name | Class |
|---|---|
| A.O. Ospedale Papa Giovanni XXIII | OTHER |
| Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec | OTHER |
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Perioperative adverse cardiovascular events are the leading cause of morbidity and mortality after noncardiac surgery. The implications of perioperative cardiac complications on morbidity and mortality, in-hospital and long-term care, and resource utilization are enormous. The continuously increasing proportion of elderly patients presenting for noncardiac surgery raises serious concerns regarding adverse cardiac events in the perioperative period. The responsibility for early diagnosis and prompt treatment of cardiac complications during surgery rests squarely with the anesthesiologist. Reliable intraoperative identification of patients at high risk for postoperative AMI and/or death is currently inadequate, but may confer substantial benefits to patients as preventive measures could be instituted. A reliable and reproducible quantitative measure of regional and global myocardial function could improve preoperative risk stratification and guide anesthetic management when acute changes in myocardial function occur.
In the present study is hypothesized that intraoperative dobutamine stress echocardiography by 2-dimensional speckle tracking echocardiography can identify patients at higher risk of perioperative adverse cardiac events.
Due to changes in study execution, analyses focused on prospectively collected physiological data examining myocardial contractile reserve and its association with postoperative myocardial injury
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DST (dobutamine-stress-test) | Experimental | dobutamine stress echocardiography performed to patients undergoing major surgery |
|
| NDST (no-dobutamine-stress-test) | No Intervention | patients refused the dobutamine stress test and transesophageal echocardiography measured the troponin level in first 24 hours after surgery |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dobutamine stress test with trans-esophageal echocardiography | Diagnostic Test | Dobutamine stress echocardiography will be performed: before skin incision and at the end of surgery. After a TEE evaluation at rest to assess myocardial structure, function and potential regional wall motion abnormalities, dobutamine infusion will be started
|
| Measure | Description | Time Frame |
|---|---|---|
| mortality | mortality | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| myocardial infarction | new ECG changes with troponin increase | within 30 days after surgery |
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Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Francesco Donatelli, MD | MUHC - McGill University Health Centre | Principal Investigator |
| Ferdinando Luca Lorini, MD | Ospedale Papa Giovanni XXIII | Principal Investigator |
| Lina Pietropaoli, MD, PhD | MUHC - McGill University Health Centre | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| MUHC | Montreal | Quebec | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22706835 | Background | Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators; Devereaux PJ, Chan MT, Alonso-Coello P, Walsh M, Berwanger O, Villar JC, Wang CY, Garutti RI, Jacka MJ, Sigamani A, Srinathan S, Biccard BM, Chow CK, Abraham V, Tiboni M, Pettit S, Szczeklik W, Lurati Buse G, Botto F, Guyatt G, Heels-Ansdell D, Sessler DI, Thorlund K, Garg AX, Mrkobrada M, Thomas S, Rodseth RN, Pearse RM, Thabane L, McQueen MJ, VanHelder T, Bhandari M, Bosch J, Kurz A, Polanczyk C, Malaga G, Nagele P, Le Manach Y, Leuwer M, Yusuf S. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA. 2012 Jun 6;307(21):2295-304. doi: 10.1001/jama.2012.5502. | |
| 21502650 |
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| Background |
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| 12009723 | Background | Hoffmann R, Marwick TH, Poldermans D, Lethen H, Ciani R, van der Meer P, Tries HP, Gianfagna P, Fioretti P, Bax JJ, Katz MA, Erbel R, Hanrath P. Refinements in stress echocardiographic techniques improve inter-institutional agreement in interpretation of dobutamine stress echocardiograms. Eur Heart J. 2002 May;23(10):821-9. doi: 10.1053/euhj.2001.2968. |
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| 16728234 | Background | Cho GY, Chan J, Leano R, Strudwick M, Marwick TH. Comparison of two-dimensional speckle and tissue velocity based strain and validation with harmonic phase magnetic resonance imaging. Am J Cardiol. 2006 Jun 1;97(11):1661-6. doi: 10.1016/j.amjcard.2005.12.063. Epub 2006 Apr 19. |
| 26498476 | Background | Aggeli C, Lagoudakou S, Felekos I, Panagopoulou V, Kastellanos S, Toutouzas K, Roussakis G, Tousoulis D. Two-dimensional speckle tracking for the assessment of coronary artery disease during dobutamine stress echo: clinical tool or merely research method. Cardiovasc Ultrasound. 2015 Oct 24;13:43. doi: 10.1186/s12947-015-0038-z. |
| 18191740 | Background | Reant P, Labrousse L, Lafitte S, Bordachar P, Pillois X, Tariosse L, Bonoron-Adele S, Padois P, Deville C, Roudaut R, Dos Santos P. Experimental validation of circumferential, longitudinal, and radial 2-dimensional strain during dobutamine stress echocardiography in ischemic conditions. J Am Coll Cardiol. 2008 Jan 15;51(2):149-57. doi: 10.1016/j.jacc.2007.07.088. |
| 22628053 | Background | Yu Y, Villarraga HR, Saleh HK, Cha SS, Pellikka PA. Can ischemia and dyssynchrony be detected during early stages of dobutamine stress echocardiography by 2-dimensional speckle tracking echocardiography? Int J Cardiovasc Imaging. 2013 Jan;29(1):95-102. doi: 10.1007/s10554-012-0074-9. Epub 2012 May 25. |
| 17765820 | Background | Pellikka PA, Nagueh SF, Elhendy AA, Kuehl CA, Sawada SG; American Society of Echocardiography. American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. J Am Soc Echocardiogr. 2007 Sep;20(9):1021-41. doi: 10.1016/j.echo.2007.07.003. No abstract available. |
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