Comparing Cardiac Chamber Measurements: TTE vs. TEE Under Anesthesia (CM-TTE-TEE)

July 2, 2025 updated by: Sunnybrook Health Sciences Centre

Reassessing Normative Cardiac Chamber Measurements: A Comparative Study of TTE and TEE Under General Anesthesia.

This study aims to compare two common ultrasound techniques used during heart surgery: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is performed by placing an ultrasound probe on the chest, while TEE involves inserting a probe into the esophagus, which provides closer and clearer images of the heart. Both methods are part of routine care for patients undergoing heart surgery.

The goal of this study is to assess how well the measurements from TTE and TEE agree in evaluating heart chamber dimensions during surgery and to investigate how factors such as anesthesia, breathing techniques affect these measurements.

This research involves 114 adult patients scheduled for heart surgery at Sunnybrook Health Sciences Centre. Participants will have TTE performed before and after surgery, and TEE will be conducted during surgery. All procedures are part of the usual standard of care.

By comparing these imaging techniques, the study seeks to provide more accurate and up-to-date guidelines for cardiac measurements, ensuring better care for patients during heart surgery.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This observational study compares transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in measuring cardiac chamber dimensions in adult patients undergoing cardiac surgery. While both techniques are integral to clinical care, TEE is typically used intraoperatively for its superior image quality, and TTE is performed preoperatively as a non-invasive diagnostic tool. However, differences in measurement values between TTE and TEE, particularly under the physiological changes induced by general anesthesia and positive end-expiratory pressure (PEEP), remain poorly understood. This study seeks to address this gap and update normative cardiac measurement values.

Study Design: A prospective observational study enrolling patients scheduled for coronary revascularization surgery at Sunnybrook Health Sciences Centre (n=114). All imaging procedures are part of routine clinical care.

Primary Objective: To evaluate the agreement between preoperative TTE and intraoperative TEE measurements of cardiac chamber dimensions.

Secondary Objectives:

  • To explore how physiological changes from general anesthesia and PEEP impact the correlation between TTE and TEE measurements.
  • To analyze how pre-existing cardiac conditions (e.g., hypertension, diabetes, atrial fibrillation) affect the agreement between these modalities.

Study Type

Observational

Enrollment (Estimated)

114

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M4N 3M5
        • Recruiting
        • Sunnybrook Health Sciences Centre
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Adult patients undergoing elective cardiac surgery, specifically coronary revascularization procedures.

Description

Inclusion Criteria:

  • Age ≥ 18, able to provide informed consent.
  • Patients scheduled for coronary revascularization cardiac surgery under general anesthesia.
  • With normal left ventricular (LV) systolic function, defined by an ejection fraction of 50% or more, and normal right ventricular (RV) systolic function.
  • Requiring intraoperative echocardiographic assessment.

Exclusion Criteria:

  • Patients with contraindications to either transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE).
  • History of poor-quality echocardiography data that preclude accurate assessment.
  • Undergoing emergency cardiac surgery.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Cardiac Surgery Patients
Patients undergoing cardiac surgery (eg., coronary revascularization) at Sunnybrook Health Sciences Centre.
Diagnostic test: Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)

Transthoracic echocardiography (TTE) is a non-invasive imaging technique performed by placing an ultrasound transducer on the chest to obtain detailed heart images. TTE is conducted preoperatively on awake patients within two weeks prior to cardiac surgery, following ASE chamber quantification guidelines.

Transesophageal echocardiography (TEE) is an invasive imaging technique where an ultrasound transducer is placed in the esophagus, providing closer and clearer images of the heart. TEE is performed intraoperatively under general anesthesia as part of routine care.

Other Names:
  • Transthoracic Echocardiography (TTE)
  • Transesophageal Echocardiography (TEE)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation between preoperative TTE and intraoperative TEE measurements
Time Frame: Within 2 weeks prior to surgery and during surgery
The correlation between preoperative transthoracic echocardiography (TTE) and intraoperative transesophageal echocardiography (TEE) measurements of cardiac chamber dimensions, including left ventricular internal dimensions, left atrial volume, and right atrial dimensions.
Within 2 weeks prior to surgery and during surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Impact of general anesthesia on correlation between TTE and TEE.
Time Frame: Within 2 weeks prior to surgery and during surgery
Impact of physiological changes induced by general anesthesia on the correlation between TTE and TEE measurements.
Within 2 weeks prior to surgery and during surgery
Impact of PEEP on correlation between TTE and TEE
Time Frame: Within 2 weeks prior to surgery and during surgery
Impact of physiological changes induced by PEEP on the correlation between TTE and TEE measurements.
Within 2 weeks prior to surgery and during surgery
Impact of cardiac conditions on correlation between TTE and TEE.
Time Frame: Within 2 weeks prior to surgery and during surgery
Impact of cardiac conditions (e.g., COPD, hypertension, history of atrial fibrillation) on the correlation between TTE and TEE measurements.
Within 2 weeks prior to surgery and during surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sunnybrook Health Sciences Centre

Investigators

  • Principal Investigator: Jacobo Moreno Garijo, MD, PhD, Sunnybrook Health Science Centre

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 27, 2025

Primary Completion (Estimated)

March 2, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

November 28, 2024

First Submitted That Met QC Criteria

November 28, 2024

First Posted (Actual)

December 4, 2024

Study Record Updates

Last Update Posted (Actual)

July 3, 2025

Last Update Submitted That Met QC Criteria

July 2, 2025

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 6347

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified participant-level data will be made available upon reasonable request to study PI following publication of full trial results.

IPD Sharing Time Frame

Data will be available following publication of the full trial results.

IPD Sharing Access Criteria

Data and supporting information will be made available following reasonable request directly to study PI.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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