Echocardiographic Left Atrial Function Assessment and Atrial Fibrillation Post-Coronary Artery Bypass Surgery
NCT ID: NCT03487419
Last Updated: 2019-05-01
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
UNKNOWN
100 participants
OBSERVATIONAL
2018-08-01
2020-12-01
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
the investigators chose electrocardiography as a reference standard for detection of Post Operative AF. LA dysfunction is diagnosed with Echocardiography
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Impact of Left Atrial Function on Postoperative Atrial Fibrillation
NCT00646997
Pre-operative Focused Transthoracic Echocardiography for Prediction of Post-operative Cardiac Complications
NCT04114474
Multiparametric MRI Assessment of Atrial Heart Disease as a Predictor of Atrial Fibrillation After Myocardial Revascularization Surgery
NCT04657835
Assessment of the Force Frequency Relationship of the Myocardium After On-pump CABG Surgery
NCT02407574
READ-POAF Pilot Studies Postoperative Atrial Fibrillation After Cardiac Surgery
NCT01530750
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Despite new-onset postoperative atrial fibrillation (NoPOAF) occurring in 20-40% of patients following coronary artery bypass graft (CABG) surgery, the underlying mechanisms are not well established. However, it has been traditionally thought to be transient and benign to the patient.
Recent evidence suggests that POAF may be more 'malignant' than previously thought, associated with follow-up mortality and morbidity.
Previously, increased left atrial (LA) size and LA dysfunction have been shown to be related to the subsequent development of atrial fibrillation (AF), stroke, myocardial infarction, and heart failure.
Also, recent studies suggest that LA dysfunction caused by the effects of oxidative stress, inflammation, and atrial fibrosis, has a role. In other words, by acute functional depression, preoperative LA dysfunction may be the starting point of the development of POAF after coronary artery bypass grafting (CABG).(8) Therefore, as the improvement in the evaluation of LA function, preoperative LA dysfunction may emerge as an important component in the identification of patients with the risk of POAF after CABG surgery.
Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain.
However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography, it is angle-independent, and allows us to measure global as well as regional atrial strain. STE is a new technique of 2D echocardiography image analysis that allows the study of regional atrial myocardial deformation expressed by a dimensionless parameter.
2-dimensional (2D) speckle tracking strain imaging is a feasible and reproducible technique for the assessment of LA function by evaluating LA deformation dynamics.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
COHORT
CROSS_SECTIONAL
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
patients develop atrial fibrillation
patients post coronary artery bypass grafting who develop atrial fibrillation post operative
No interventions assigned to this group
patients who not develop atrial fibrillation
patients post coronary artery bypass grafting who don't develop atrial fibrillation post operative
No interventions assigned to this group
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Patient age more than18 years old.
Exclusion Criteria
* Hyperthyroidism or hypothyroidism.
* Renal failure requiring hemodialysis .
* Moderate to severe valvular heart disease.
* Current use of antiarrhythmic drugs .
* Recent myocardial infarction within a month before surgery.
* Patient with redo CABG.
18 Years
ALL
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
National Heart Institute, Egypt
OTHER_GOV
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
hossam ahmed hamed hussein
Principal Investigator
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
National Heart Institute
Cairo, Kit Kat, Egypt
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Echahidi N, Pibarot P, O'Hara G, Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008 Feb 26;51(8):793-801. doi: 10.1016/j.jacc.2007.10.043.
Haghjoo M. Pharmacological and nonpharmacological prevention of atrial fibrillation after coronary artery bypass surgery. J Tehran Heart Cent. 2012 Winter;7(1):2-9. Epub 2012 Feb 28.
Levy D, Kannel WB. Postoperative atrial fibrillation and mortality: do the risks merit changes in clinical practice? J Am Coll Cardiol. 2004 Mar 3;43(5):749-51. doi: 10.1016/j.jacc.2003.12.011. No abstract available.
Borde D, Gandhe U, Hargave N, Pandey K, Mathew M, Joshi S. Prediction of postoperative atrial fibrillation after coronary artery bypass grafting surgery: is CHA 2 DS 2 -VASc score useful? Ann Card Anaesth. 2014 Jul-Sep;17(3):182-7. doi: 10.4103/0971-9784.135841.
Mariscalco G, Engstrom KG. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. Ann Thorac Surg. 2009 Dec;88(6):1871-6. doi: 10.1016/j.athoracsur.2009.07.074.
Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006 Jun 20;47(12):2357-63. doi: 10.1016/j.jacc.2006.02.048.
Elahi MM, Flatman S, Matata BM. Tracing the origins of postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenon. Eur J Cardiovasc Prev Rehabil. 2008 Dec;15(6):735-41. doi: 10.1097/HJR.0b013e328317f38a.
Her AY, Kim JY, Kim YH, Choi EY, Min PK, Yoon YW, Lee BK, Hong BK, Rim SJ, Kwon HM. Left atrial strain assessed by speckle tracking imaging is related to new-onset atrial fibrillation after coronary artery bypass grafting. Can J Cardiol. 2013 Mar;29(3):377-83. doi: 10.1016/j.cjca.2012.06.006. Epub 2012 Aug 15.
Cianciulli TF, Saccheri MC, Lax JA, Bermann AM, Ferreiro DE. Two-dimensional speckle tracking echocardiography for the assessment of atrial function. World J Cardiol. 2010 Jul 26;2(7):163-70. doi: 10.4330/wjc.v2.i7.163.
Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP. Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr. 2009 Mar;22(3):299-305. doi: 10.1016/j.echo.2008.12.017.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
left atrial speckle tracking
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.