SHAPE Test for Preoperative Risk Stratification

NCT ID: NCT05743673

Last Updated: 2025-12-18

Study Results

Results pending

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.

Recruitment Status

RECRUITING

Total Enrollment

371 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-05-03

Study Completion Date

2026-05-29

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Primary Objective Characterizing precise functional capacity in surgical patients is critical for risk stratification and identification of patients at high risk for perioperative complications. The primary objective for the study is to evaluate the feasibility of effective subject recruitment of an FDA-approved simplified cardiopulmonary exercise testing apparatus in adults \>60 years old prior to moderate to high-risk surgery. In addition, by development of a validation cohort of older adults, defined as \>60 years old, self-reporting \>4 METS and with a score of \<2 on the revised cardiac risk index (RCRI)1 we will compare its effectiveness when compared to conventional preoperative evaluation measures (METS determination by standard scoring and Duke Activity Status Index) to SHAPE™ testing.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The submaximal heart and pulmonary evaluation (SHAPE™) test is an FDA approved cardiopulmonary exercise testing (CPET) system that provides a rapid and non-invasive way of characterizing cardiopulmonary reserve in a variety of medical conditions3,4. Traditional CPET testing has demonstrated predictive power in the assessment of postoperative mortality, hospital length of stay and other postoperative complications after lung resection, abdominal aortic aneurysm repair and liver transplants5-7. A unique advantage of SHAPE™ testing is that functional capacity variables are both obtained at rest and during sub-maximal exercise, potentially mimicking elicited conditions associated with surgical stress, as well as assist in determining the specific component of the physiological system under duress during testing (cardiac vs. pulmonary). Additionally, unlike conventional CPET, a maximum exercise effort is not required, making it an attractive option for patients with cardiopulmonary or musculoskeletal disorders and elderly patients who are unable to undergo the higher intensity exercise testing associated with traditional CPET. Finally, investigation of unique SHAPE™ variables (e.g. GXcap/Δend-tidal C02) which have been observed to be sensitive performance indicators for a variety of cardiovascular diseases such as heart failure with preserved ejection fraction, may prove more sensitive to traditional CPET variables or conventional echocardiography3.

This is a prospective, non-randomized feasibility study to evaluate the effectiveness of subject recruitment of an FDA-approved simplified cardiopulmonary exercise testing apparatus in adults \>60 years old prior to moderate to high-risk surgery. Pre-screened research subjects will be approached by telephone or in-person within the pre-surgical evaluation clinic prior to their surgery. We hypothesize that \>25% of eligible subjects will be recruited in the investigation. A single 35 minute in-person session will be performed where subjective metabolic equivalents will be assessed, and experimental session of the SHAPE™ medical system testing apparatus. Research subjects will then be released after survey. A follow-up telephone call at 24 hours will assess any adverse events related to the experimental session. For the period of 30 days after their scheduled surgery, minor and major postoperative complications will be extracted from the electronic medical record.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Perioperative/Postoperative Complications Aerobic Capacity

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

perioperative risk stratification submaximal cardiopulmonary exercise testing postoperative complications perioperative complications

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Validation Cohort

Older subjects (\>60 years old) presenting for moderate to high-risk surgical procedure with reported subjective metabolic equivalents of \>4 METS and with a score of \<4 on the revised cardiac risk index (RCRI) undergoing submaximal exercise testing.

Shape II

Intervention Type DEVICE

cardiopulmonary exercise testing apparatus

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Shape II

cardiopulmonary exercise testing apparatus

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aged \>60 years
* Scheduled for pre-surgical evaluation for moderate to high-risk surgical procedure.
* RCRI \<2 based on screening of preoperative co-morbidities.
* Provision of signed and dated informed consent form

Exclusion Criteria

1. Age \<60 years old
2. Subjective METS \<4
3. Inability to give independent informed consent
4. Revised Cardiac Risk Index (RCRI) \>2
5. Neurological impairment with motor limitations
6. Mental impairment leading to inability to cooperate
7. Recent NSTEMI or STEMI type myocardial infarction (within 6 months)
8. Angina (stable or unstable, within 6 months)
9. Uncorrected severe valvular heart disease (severe aortic, tricuspid, or mitral stenosis)
10. Recent exacerbation of congestive heart failure (requiring hospitalization, within 6 months)
11. Acute pulmonary embolism or deep vein thrombosis (within past 6 months)
12. Uncontrolled pulmonary edema
13. Uncontrolled symptomatic arrhythmias
14. Active endocarditis
15. Acute myocarditis or pericarditis
16. Active wheezing or home oxygen use
17. Recent exacerbation of chronic obstructive pulmonary disease or asthma or pneumonia (requiring hospitalization, within 6 months)
18. Inability to perform components of the SHAPE test (severe hip flexion limitation, severe osteoarthritis of knee or hip, limb immobilization, ambulation with a walker, can or crutches, baseline balance irregularities
19. Diagnosis of vertigo
20. Known allergic reactions to components of the SHAPE medical system apparatus disposable mouthpiece.
21. Active enrollment in an interventional clinical trial within the enrollment period of the study.
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Yale University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Zyad Carr

Associate Professor, Department of Anesthesiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Zyad J Carr, M.D.

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Zyad J Carr, M.D.

Role: CONTACT

Phone: 203-785-3689

Email: [email protected]

References

Explore related publications, articles, or registry entries linked to this study.

Ohnishi H, Inaba H, Mochizuki H, Kosuzume H. Mechanism of action of AC-1370 on phagocyte functions. Antimicrob Agents Chemother. 1984 Jan;25(1):88-92. doi: 10.1128/AAC.25.1.88.

Reference Type BACKGROUND
PMID: 6703687 (View on PubMed)

Bennett H, Parfitt G, Davison K, Eston R. Validity of Submaximal Step Tests to Estimate Maximal Oxygen Uptake in Healthy Adults. Sports Med. 2016 May;46(5):737-50. doi: 10.1007/s40279-015-0445-1.

Reference Type BACKGROUND
PMID: 26670455 (View on PubMed)

Bernstein EJ, Mandl LA, Gordon JK, Spiera RF, Horn EM. Submaximal heart and pulmonary evaluation: a novel noninvasive test to identify pulmonary hypertension in patients with systemic sclerosis. Arthritis Care Res (Hoboken). 2013 Oct;65(10):1713-8. doi: 10.1002/acr.22051.

Reference Type BACKGROUND
PMID: 23740875 (View on PubMed)

Bohannon RW, Crouch RH. Two-Minute Step Test of Exercise Capacity: Systematic Review of Procedures, Performance, and Clinimetric Properties. J Geriatr Phys Ther. 2019 Apr/Jun;42(2):105-112. doi: 10.1519/JPT.0000000000000164.

Reference Type BACKGROUND
PMID: 29210933 (View on PubMed)

Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.

Reference Type BACKGROUND
PMID: 7154893 (View on PubMed)

Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999 Oct 28;341(18):1351-7. doi: 10.1056/NEJM199910283411804.

Reference Type BACKGROUND
PMID: 10536127 (View on PubMed)

Devereaux PJ, Goldman L, Cook DJ, Gilbert K, Leslie K, Guyatt GH. Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. CMAJ. 2005 Sep 13;173(6):627-34. doi: 10.1503/cmaj.050011.

Reference Type BACKGROUND
PMID: 16157727 (View on PubMed)

Ferguson M, Shulman M. Cardiopulmonary Exercise Testing and Other Tests of Functional Capacity. Curr Anesthesiol Rep. 2022;12(1):26-33. doi: 10.1007/s40140-021-00499-6. Epub 2021 Nov 20.

Reference Type BACKGROUND
PMID: 34840532 (View on PubMed)

Gerson MC, Hurst JM, Hertzberg VS, Baughman R, Rouan GW, Ellis K. Prediction of cardiac and pulmonary complications related to elective abdominal and noncardiac thoracic surgery in geriatric patients. Am J Med. 1990 Feb;88(2):101-7. doi: 10.1016/0002-9343(90)90456-n.

Reference Type BACKGROUND
PMID: 2301435 (View on PubMed)

Grocott MP, Browne JP, Van der Meulen J, Matejowsky C, Mutch M, Hamilton MA, Levett DZ, Emberton M, Haddad FS, Mythen MG. The Postoperative Morbidity Survey was validated and used to describe morbidity after major surgery. J Clin Epidemiol. 2007 Sep;60(9):919-28. doi: 10.1016/j.jclinepi.2006.12.003. Epub 2007 May 7.

Reference Type BACKGROUND
PMID: 17689808 (View on PubMed)

Hansen D, Jacobs N, Thijs H, Dendale P, Claes N. Validation of a single-stage fixed-rate step test for the prediction of maximal oxygen uptake in healthy adults. Clin Physiol Funct Imaging. 2016 Sep;36(5):401-6. doi: 10.1111/cpf.12243. Epub 2015 Jun 5.

Reference Type BACKGROUND
PMID: 26046474 (View on PubMed)

Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989 Sep 15;64(10):651-4. doi: 10.1016/0002-9149(89)90496-7.

Reference Type BACKGROUND
PMID: 2782256 (View on PubMed)

Kallianos A, Rapti A, Tsimpoukis S, Charpidou A, Dannos I, Kainis E, Syrigos K. Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection. In Vivo. 2014 Nov-Dec;28(6):1013-20.

Reference Type BACKGROUND
PMID: 25398794 (View on PubMed)

Khatri V, Neal JE, Burger CD, Lee AS. Prognostication in Pulmonary Arterial Hypertension with Submaximal Exercise Testing. Diseases. 2015 Feb 6;3(1):15-23. doi: 10.3390/diseases3010015.

Reference Type BACKGROUND
PMID: 28943605 (View on PubMed)

Carr ZJ, Charchaflieh J, Brenes-Bastos A, He H, Lin HM, Jankelovits A, Gu E, Zafar J, Ghali F, Tan WS, Heerdt P. Preoperative submaximal cardiopulmonary exercise testing and its association with early postoperative complications. BJA Open. 2025 Apr 24;14:100407. doi: 10.1016/j.bjao.2025.100407. eCollection 2025 Jun.

Reference Type DERIVED
PMID: 40421445 (View on PubMed)

Carr ZJ, Agarkov D, Li J, Charchaflieh J, Brenes-Bastos A, Freund J, Zafar J, Schonberger RB, Heerdt P. Implementation of Brief Submaximal Cardiopulmonary Testing in a High-Volume Presurgical Evaluation Clinic: Feasibility Cohort Study. JMIR Perioper Med. 2025 Feb 17;8:e65805. doi: 10.2196/65805.

Reference Type DERIVED
PMID: 39773953 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2000033885

Identifier Type: -

Identifier Source: org_study_id