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| ID | Type | Description | Link |
|---|---|---|---|
| 82570593 | Other Grant/Funding Number | National Natural Science Foundation of China (NSFC) |
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| Name | Class |
|---|---|
| Yichang Central People's Hospital | OTHER |
| Wuhan Central Hospital | OTHER |
| Huangshi Central Hospital | OTHER |
| Wuhan Third Hospital |
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The goal of this multicenter, double-blind, randomized controlled trial is to evaluate the efficacy and safety of low-intensity focused ultrasound (LIFU) stellate ganglion modulation for improving autonomic function and sleep quality in perioperative cardiovascular disease patients.
The main questions it aims to answer are:
Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low-Intensity Focused Ultrasound (LIFU) Intervention Arm | Experimental | Subjects in this arm will receive low-intensity focused ultrasound (LIFU) intervention on the left stellate ganglion. Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session, once daily for 3-7 consecutive days. All subjects will receive guideline-concordant standard perioperative cardiovascular care, including surgery and indicated medications. |
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| Sham Ultrasound Control Arm (Placebo) | Placebo Comparator | Subjects in this arm will receive sham ultrasound intervention with identical operational procedures, device appearance, and parameter settings (no actual energy output) as the intervention arm. Sessions are once daily for 3-7 consecutive days. All subjects will receive the same guideline-concordant standard perioperative cardiovascular care as the intervention arm. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low-intensity focused ultrasound (LIFU) targeting the left stellate ganglion | Device | The experimental group receives active low-intensity focused ultrasound (LIFU) treatment: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with parameters set as power 2.0W, frequency 1MHz, duty cycle 50%, 30 minutes per session, once daily for 3-7 consecutive days. All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period. |
| Measure | Description | Time Frame |
|---|---|---|
| SDNN | Standard deviation of all normal-to-normal intervals measured by wearable Holter monitor; Unit: ms; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| Total sleep duration | Total sleep time measured by wearable sleep monitor; Unit: hours; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| SDANN | Standard deviation of the averages of NN intervals in all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| SDNN Index | Mean of the standard deviations of all NN intervals for all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| RMSSD | Root mean square of successive differences between normal heartbeats; Unit: ms; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| pNN50 | Percentage of successive NN intervals that differ by more than 50 ms; Unit: %; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| LF power | Low frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors. |
| Measure | Description | Time Frame |
|---|---|---|
| IL-1β level | Serum IL-1β concentration; Unit: pg/mL. | Pre-operative 24 hours and Post-operative 72 hours |
| Norepinephrine (NE) level | Serum norepinephrine concentration; Unit: pg/mL. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Songyun Wang, MD | Contact | +86 13871262107 | wsy7982@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Huangshi Central Hospital | Huangshi | Hubei | 430060 | China |
Due to considerations for protecting participant privacy, undetermined data ownership, or the absence of a detailed data-sharing policy.
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| OTHER |
| Xiangyang Central Hospital | OTHER |
| Jingzhou Central Hospital | OTHER |
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| Sham low-intensity focused ultrasound targeting the left stellate ganglion | Device | The control group receives sham low-intensity focused ultrasound intervention: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with the same instrument appearance, operation process, parameter setting display (power 2.0W, frequency 1MHz, duty cycle 50%), duration (30 minutes per session, once daily for 3-7 consecutive days) and subject experience as the experimental group, but no actual ultrasound energy is output. All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period. |
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| Pre-operative 24 hours and Post-operative 72 hours |
| HF power | High frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| TP | Total power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| LF/HF ratio | Ratio of low frequency to high frequency power; Unit: ratio; Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| Wakefulness percentage | Percentage of time awake during sleep period; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| Insomnia percentage | Percentage of time with insomnia symptoms during sleep period; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| REM sleep percentage | Percentage of rapid eye movement sleep during total sleep time; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| N1 sleep stage percentage | Percentage of N1 sleep stage during total sleep time; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| N2 and N3 sleep stages percentage | Combined percentage of N2 and N3 sleep stages during total sleep time; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| Sleep efficiency | Ratio of total sleep time to time in bed; Unit: %; Measurement device: Wearable sleep monitor. | Pre-operative 24 hours and Post-operative 72 hours |
| Pre-operative 24 hours and Post-operative 72 hours |
| Brain-derived neurotrophic factor (BDNF) level | Serum brain-derived neurotrophic factor concentration; Unit: pg/mL. | Pre-operative 24 hours and Post-operative 72 hours |
| Pittsburgh Sleep Quality Index (PSQI) score | Subjective sleep quality assessed using the Pittsburgh Sleep Quality Index questionnaire; Unit: Score on a 0-21 scale, where higher scores indicate worse sleep quality; Method of Measurement: Self-administered questionnaire. | Pre-operative 24 hours and Post-operative 72 hours |
| Number of atrial arrhythmias | Measurement: count of atrial arrhythmia episodes. Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| Duration of atrial arrhythmias | Measurement: Duration of atrial arrhythmia episodes. Measurement device: wearable Holter monitors. | Pre-operative 24 hours and Post-operative 72 hours |
| TNF-α level | Serum TNF-α concentration; Unit: pg/mL. | Pre-operative 24 hours and Post-operative 72 hours |
| Neuropeptide Y (NPY) level | Serum neuropeptide Y concentration; Unit: pg/mL. | Pre-operative 24 hours and Post-operative 72 hours |
| Melatonin level | Serum melatonin concentration; Unit: pg/mL. | Pre-operative 24 hours and Post-operative 72 hours |
| Jingzhou Central Hospital | Jingzhou | Hubei | 430060 | China |
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| Renmin Hospital of Wuhan University | Wuhan | Hubei | 430060 | China |
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| Wuhan Central Hospital | Wuhan | Hubei | 430060 | China |
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| Wuhan Third Hospital | Wuhan | Hubei | 430060 | China |
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| Xiangyang Central Hospital | Xiangyang | Hubei | 430060 | China |
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| Yichang Central People's Hospital | Yichang | Hubei | 430060 | China |
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| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D007319 | Sleep Initiation and Maintenance Disorders |
| ID | Term |
|---|---|
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D001523 | Mental Disorders |
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