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Effect of Dapagliflozin on Right Ventricular-Pulmonary Artery Coupling After Off-Pump Coronary Atery Bypass Grafting (DAPA-RV-CABG)

2. juni 2026 opdateret af: Samson Badalyan, Pyatigorsk City Clinical Hospital Number 1

Effect of Dapagliflozin on Right Ventricular-Pulmonary Artery Coupling After Off-Pump Coronary Artery Bypass Grafting: a Prospective Single-Center Study

This prospective, single-center observational study evaluates the effect of dapagliflozin 10 mg/day on right ventricular-pulmonary artery coupling measured by the TAPSE/PASP ratio in 72 patients with left ventricular ejection fraction <50% after off-pump coronary artery bypass grafting (OPCAB). The primary outcome is the change in TAPSE/PASP ratio from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin therapy).

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Detaljeret beskrivelse

Patients undergo echocardiography at three time points: pre-operatively (T0), at 1 month post-surgery before dapagliflozin initiation (T1), and at 7 months post-surgery after 6 months of dapagliflozin 10 mg/day (T2).

The primary objective is to evaluate the change in the TAPSE/PASP ratio from T1 to T2.

Secondary objectives are to evaluate changes from T1 to T2 in:

  • Pulmonary artery systolic pressure (PASP)
  • Pulmonary vascular resistance (PVR)
  • Right ventricular fractional area change (RV FAC)
  • Left ventricular ejection fraction (LVEF)
  • NT-proBNP levels
  • Kansas City Cardiomyopathy Questionnaire-23 (KCCQ-23) overall summary score

The study aims to provide mechanistic insight into the effects of SGLT2 inhibition on right ventricular-pulmonary artery coupling after off-pump coronary artery bypass grafting.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

72

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Syune V. Markosyan, MD.
  • Telefonnummer: +79633876510
  • E-mail: ssm8883@gmail.com

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients with LVEF below 50% undergoing elective isolated off-pump coronary artery bypass grafting at a single center.

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years
  • Elective isolated off-pump coronary artery bypass grafting (OPCAB)
  • Left ventricular ejection fraction (LVEF) < 50% documented on pre-operative echocardiography
  • Written informed consent

Exclusion Criteria:

  • Concomitant valve surgery
  • Emergency or urgent CABG
  • Conversion to on-pump during surgery
  • Perioperative myocardial infarction (as defined by the Fourth Universal Definition of MI)
  • Cardiogenic shock
  • More than moderate valvular heart disease
  • Persistent atrial fibrillation or atrial flutter at the time of echocardiographic examination)
  • Previous CABG or any prior cardiac surgery
  • Severe chronic kidney disease (eGFR < 25 mL/min/1.73 m²)
  • Contraindication to SGLT2 inhibitors
  • Inability to obtain adequate echocardiographic windows
  • Pregnancy or breastfeeding

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Dapagliflozin Group
Patients receiving dapagliflozin 10 mg once daily starting at 1 month after off-pump CABG

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in TAPSE/PASP Ratio
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
The change in the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery pressure (PASP) from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Pulmonary Artery Systolic Pressure (PASP)
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in pulmonary artery systolic pressure (PASP) calculated as 4 x (TR Vmax)˄2 + estimated right atrial pressure (RAP) from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
Change in Pulmonary Vascular Resistance (PVR)
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in pulmonary vascular resistance (PVR) calculated as (TR Vmax / VTI RVOT) x 10 + 0.16 (wood units) from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
Change in NT-proBNP Levels
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (pg/ml) from 1 month after surgery (before dapagliflozin) to 7 month after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
Change in Quality of Life (KCCQ-23 Overall Summary Score)
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in qulity of life assessed by the Kansas City Cardiomyopathy Questionnaire-23 (KCCQ-23) Overall Summary Score (range 0 to 100), higher score indicates better quality of life) from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
Change in Right Ventricular Fractional Area Change (RV FAC)
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in right ventricular fractional area change (RV FAC) calculated as (RVEDA - RVESA) / RVEDA x 100 (%) from 1 month after surgery (before dapagliflozin) to 7 months after surgery ( after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
Change in Left Ventricular Ejection Fraction (LVEF)
Tidsramme: 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)
The change in left ventricular ejection fraction (LVEF) calculated by biplane Simpson method (%) from 1 month after surgery (befiore dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin 10 mg/day)
1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Pyatigorsk City Clinical Hospital Number 1

Efterforskere

  • Ledende efterforsker: Samson S. Badalyan, MD, PhD, Pyatigorsk City Clinical Hospital Number 1

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. november 2027

Studieafslutning (Anslået)

1. januar 2028

Datoer for studieregistrering

Først indsendt

12. maj 2026

Først indsendt, der opfyldte QC-kriterier

18. maj 2026

Først opslået (Faktiske)

22. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. juni 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • DAPA-RV-CABG (Anden identifikator: ClinicalTrials.gov PRS)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

IPD-planbeskrivelse

Individual participant data will be available upon reasonable request to the Principal Investigator after study completion and publication

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