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Cardiac Disease clinical trials

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NCT ID: NCT06386094 Recruiting - Cardiac Disease Clinical Trials

Cardiac Dysfunction in Patients With Non-alcoholic Fatty Liver Disease

Start date: July 15, 2023
Phase:
Study type: Observational

Cirrhotic cardiomyopathy is seen as a blunted contractile responsiveness to stress, and/or altered diastolic relaxation with electrophysiological abnormalities, in absence of known cardiac disease. Left ventricular diastolic dysfunction (LVDD) is associated with risk of hepatorenal syndrome (HRS) , septic shock. , heart failure in the perioperative period following liver transplantation, and after trans-jugular intrahepatic portosystemic shunt (TIPS) insertion . The echocardiographic E/e' ratio is a predictor of survival in LVDD, with multiple studies, including prospective data from our Centre. The inability of the heart to cope with stress or sepsis induced circulatory failure is a key concept of the increased mortality risk due to LVDD. In view of the metabolic syndrome and diabetes epidemic and an increasing number of patients being diagnosed with non-alcoholic fatty liver disease, there is increased risk of developing cardiac dysfunction due to multiple comorbidities including coronary artery disease, hypertensive heart disease, cirrhotic cardiomyopathy, which are contributors to overall cardiovascular risk of mortality.

NCT ID: NCT06294119 Recruiting - Depression Clinical Trials

Multivariate Approach to the Numerical Assessment of Cortical - Autonomic - VAscular Dynamic Interplay

Start date: February 8, 2024
Phase: N/A
Study type: Interventional

MANCAVA sets out fundamental methodologies for characterizing human fundamental physiological system interactions at a whole-body level, particularly focusing on the interplay among cortical brain activity, autonomic function, and cerebrovascular autoregulatory mechanisms. By investigating the complex, time-varying mechanisms underlying the multisystem dynamic interactions, novel methods linking various brain areas and reflex functions to target organs and districts such as heart and circulatory system are proposed with the clinical aim linked to the emerging topic of depression. In this scenario, proper new mathematical tools will allow a significant leap from the current state of the art, paving the way towards a new understanding of leading comorbid contributors to global diseases such as cardiac and cerebrovascular morbidity in mood disorders. In turn, this will provide an integration among physiological and psychological dimensions for a more holistic view on depression. Researchers, professionals, and patients will all benefit from a comprehensive assessment of brain-mind-body interplay, leading to the new extended definition of default mode/mood network, neurovascular-evoked responses to autonomic stimuli, brain-autonomic consequences of emotional responses, and physiological substrates of depressive states.

NCT ID: NCT06285773 Recruiting - Cardiac Disease Clinical Trials

Recto-intercostal Fascial Plane Block and Pecto-intercostal Fascial Plane Block for Cardiac Surgery

Start date: February 25, 2024
Phase: N/A
Study type: Interventional

In cardiac surgeries performed with median sternotomy, mediastinal and thoracic tube placement sites are outside the area of effect of parasternal blocks, and sometimes the sternotomy incision extends below the T6 dermatome. Recto intercostal fascial plane block (RIFPB) has been defined as a complementary block for analgesia of this region. This study aims to evaluate the effectiveness of the combination of ultrasound-guided recto-intercostal fascial plane block and pectointercostal fascial block for postoperative analgesia management after open heart surgery (coronary artery bypass) with median sternotomy.

NCT ID: NCT06275971 Recruiting - Diabetes Mellitus Clinical Trials

Effectiveness of Continuous Glucose Monitoring System Among Cardiac Surgery Patients

Start date: November 24, 2022
Phase: N/A
Study type: Interventional

The aim of this study is to assess the level of glycemic control and the incidence of surgery-related complications in cardiac patients post-surgery when Continuous Glucose Monitoring (CGM) is utilized, as compared to traditional methods of arterial/venous blood sampling and Point-of-Care Testing (POCT) for glucose monitoring.

NCT ID: NCT06275100 Recruiting - Clinical trials for Coronary Artery Disease

PREhabilitation in Patients Awaiting Acute Inpatient Cardiac SurgEry

(PREP-ACE)
Start date: April 3, 2024
Phase: N/A
Study type: Interventional

This is a single centre, single arm pilot feasibility study to determine the feasibility and practicality of prehabilitation in acute inpatients waiting for cardiac surgery. We will be looking into participant eligibility, acceptability, recruitment rates, completion rates and barriers to implementing a prehabilitation programme. Secondary outcomes include safety (incidence of adverse events directly related to the study), improvement in 6 minutes walk test (6MWT), hand grip strength, quality of life, and spirometry. At the end of the trial, we will be seeking the feedback of the participants to help us improve the design further.

NCT ID: NCT06248320 Recruiting - Clinical trials for Postoperative Complications

Sigh Ventilation on Postoperative Hypoxemia in Cardiac Surgery

Start date: February 25, 2024
Phase: N/A
Study type: Interventional

Postoperative pulmonary complications (PPCs) remain a frequent event after pump-on cardiac surgery and are mostly characterized by postoperative hypoxemia.These complications are significant contributors to prolonged intensive care unit admissions and an escalation in in-hospital mortality rates. The dual impact of general anesthesia with invasive mechanical ventilation results in ventilator-induced lung injury, while cardiac surgery introduces additional pulmonary insults. These include systemic inflammatory responses initiated by cardiopulmonary bypass and ischemic lung damage consequent to aortic cross-clamping. Contributing factors such as blood transfusions and postoperative pain further exacerbate the incidence of PPCs by increasing the permeability of the alveolo-capillary barrier and disrupting mucociliary functions, often culminating in pulmonary atelectasis. Protective ventilation strategies, inspired by acute respiratory distress syndrome (ARDS) management protocols, involve the utilization of low tidal volumes (6-8mL/kg predicted body weight). However, the uniform application of low tidal volumes, especially when combined with the multifactorial pulmonary insults inherent to cardiac surgery, can precipitate surfactant dysfunction and induce atelectasis. The role of pulmonary surfactant in maintaining alveolar stability is critical, necessitating continuous synthesis to sustain low surface tension and prevent alveolar collapse. The most potent stimulus for surfactant secretion is identified as the mechanical stretch of type II pneumocytes, typically induced by larger tidal volumes. This background sets the foundation for a research study aimed at assessing the safety and efficacy of incorporating sighs into perioperative protective ventilation. This approach is hypothesized to mitigate postoperative hypoxemia and reduce the incidence of PPCs in patients undergoing scheduled on-pump cardiac surgery.

NCT ID: NCT06205875 Recruiting - Surgery Clinical Trials

High Versus Low Dose Serratus Anterior Plane Block After Minimally Invasive Valve Surgery.

Start date: February 21, 2024
Phase: N/A
Study type: Interventional

This study aims to compare the efficacy and quality of pain relief provided by the high-dose serratus anterior plane (SAP) block with the standard SAP block in preventing and treating acute postoperative pain after total endoscopic aortic or mitral valve surgery.

NCT ID: NCT06164171 Recruiting - Cardiac Disease Clinical Trials

Transesophageal Echocardiography (TEE) and Simulation : a Preferred Learning Path

TEE
Start date: June 9, 2020
Phase:
Study type: Observational

Transesophageal echocardiography (TEE) has gradually become the technique of choice for continuous functional examination of the heart despite the significant training required for its interpretation. It has proven to be the safest, fastest, and most reliable technique for diagnosing most intra- and postoperative hemodynamic problems. Indeed, the transesophageal route is particularly well adapted to the situation of intubated patients, whether in the operating room, in the outpatient department or in intensive care. It offers images that are easier to obtain and of better quality than the transthoracic route; it can be performed without interfering with surgical activity or resuscitation. However, TEE training is often poor during the DES training in anesthesia and resuscitation, reserved for the few interns who will learn in a specific department where TEE is used on a daily basis. Thus, simulation is a logical and recognized means by which technical aspects, mechanisms involved in the understanding of a situation, reasoning and decision making can be analyzed and improved. The RFE SFAR 2019 recommendations suggest the use of simulation for the learning of technical gestures in initial training in order to improve their acquisition. This study is therefore part of a technical and diagnostic improvement of a practice, which appears to be essential in several fields in anesthesia and intensive care, for a technique still not sufficiently acquired by many future practitioners.

NCT ID: NCT06154473 Recruiting - Cardiac Disease Clinical Trials

Assessment of Patients Undergoing Cardiac Surgery and Admitted to the Intensive Care Unit

BraSIS-2
Start date: September 1, 2023
Phase:
Study type: Observational

The objective of this study is to investigate the incidence of death and early postoperative complications, identify potential risk factors, and examine the demographic characteristics of patients and epidemiology of cardiovascular procedures. Our hypothesis is that gaining a more comprehensive understanding of the characteristics of patients who undergo cardiac surgery has the potential to improve outcomes for this patient profile. Thus, information was sought regarding the patient characteristics, surgeries performed, anesthesia administered, incidence of intraoperative and postoperative complications, and risk factors associated with complication and mortality in the ICU. The main questions it aims to answer are: - Incidence of mortality or severe postoperative complications that occur within the first 3 postoperative days or until discharge from the ICU. - Risk factors associated with severe complications in patients who undergo cardiac surgery. - Characteristics of patients, anesthesia and surgical procedures performed - Incidence of severe intraoperative complications and moderate postoperative complications - Evaluate the influence of accumulated fluid balance on outcomes, mortality, and length of ICU stay. - Evaluate mortality in the ICU. - Describe the risk factors associated with mortality.

NCT ID: NCT06149143 Recruiting - Cardiac Disease Clinical Trials

Cardiac Performance System Data Collection Study - Minnesota

Start date: October 3, 2023
Phase:
Study type: Observational

Non-significant risk device study to conduct evaluation of the performance of new device for monitoring of cardiac function (based on previous iterations 510(k) 173156)