Low-Intensity Focused Ultrasound Targeting the Stellate Ganglion for Regulating Autonomic Nerve Function and Sleep Quality in Perioperative Patients With Cardiovascular Diseases (US-REST)
Low-Intensity Focused Ultrasound Targeting the Stellate Ganglion for Regulating Autonomic Nerve Function and Sleep Quality in Perioperative Patients With Cardiovascular Diseases: A Multicenter, Double-Blind, Randomized Controlled Trial
The goal of this multicenter, double-blind, randomized controlled trial is to evaluate the efficacy and safety of low-intensity focused ultrasound (LIFU) stellate ganglion modulation for improving autonomic function and sleep quality in perioperative cardiovascular disease patients.
The main questions it aims to answer are:
- Does LIFU improve heart rate variability and sleep characteristics from baseline at 3-7 days post-surgery compared to sham ultrasound?
- Does LIFU improve serological markers, vital signs, Pittsburgh Sleep Quality Index (PSQI), and reduce >30-second perioperative arrhythmias?
- What is the safety profile of LIFU in this population? 200 eligible patients will be randomized 1:1 to receive either active LIFU (2.0W, 1MHz, 50% duty cycle, 30min daily for 3-7 days) plus standard care, or identical sham ultrasound plus standard care. A four-party double-blind design (subjects, operators, assessors, analysts) will be implemented. The study will run from May 1, 2026 to April 1, 2027 at 6 centers in China.
Participants will:
- Complete pre-surgery screening and baseline assessments (PSQI, 12h ECG/sleep monitoring, residual blood sample collection)
- Receive daily assigned ultrasound intervention for 3-7 consecutive days post-surgery
- Undergo 72h continuous ECG monitoring post-surgery, and repeat assessments at 3-7 days
- Have all adverse events and arrhythmias recorded throughout the study
- May withdraw voluntarily at any time without affecting routine medical care
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Songyun Wang, MD
- Número de teléfono: +86 13871262107
- Correo electrónico: wsy7982@126.com
Ubicaciones de estudio
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Hubei
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Huangshi, Hubei, Porcelana, 430060
- Aún no reclutando
- Huangshi Central Hospital
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Contacto:
- Kai Zhang, MD
- Número de teléfono: +86 13907230225
- Correo electrónico: zk9620@163.com
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Jingzhou, Hubei, Porcelana, 430060
- Aún no reclutando
- Jingzhou Central Hospital
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Contacto:
- Keping Yang, MD
- Número de teléfono: +86 18107168679
- Correo electrónico: 30461400@qq.com
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Wuhan, Hubei, Porcelana, 430060
- Reclutamiento
- Renmin Hospital of Wuhan University
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Contacto:
- Songyun Wang, MD
- Número de teléfono: +86 13871262107
- Correo electrónico: wsy7982@126.com
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Wuhan, Hubei, Porcelana, 430060
- Aún no reclutando
- Wuhan Third Hospital
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Contacto:
- Dongsheng Li, MD
- Número de teléfono: +86 18872288277
- Correo electrónico: lidongsheng693@sina.com
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Wuhan, Hubei, Porcelana, 430060
- Aún no reclutando
- Wuhan Central Hospital
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Contacto:
- Long Wang, MD
- Número de teléfono: +86 15761600527
- Correo electrónico: 319921605@qq.com
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Xiangyang, Hubei, Porcelana, 430060
- Aún no reclutando
- Xiangyang Central Hospital
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Contacto:
- Tongjian Zhu, MD
- Número de teléfono: +86 15971160197
- Correo electrónico: whuzhutongjian@126.com
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Yichang, Hubei, Porcelana, 430060
- Aún no reclutando
- Yichang Central People's Hospital
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Contacto:
- Zhuli Guo, MD
- Número de teléfono: +86 15271455251
- Correo electrónico: guozhuli@yczxyy.com
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Diagnosed with cardiovascular disease (CVD) and scheduled to undergo cardiology-related surgical treatment
- Able to receive and tolerate the aforementioned cardiology-related surgical treatment
- Aged between 18 and 79 years (inclusive), with no restriction on gender
- Agree to accept random allocation of the treatment strategies
- With clear consciousness, no severe mental disorders or cognitive impairment; voluntarily sign the written informed consent form (ICF) and are willing to actively cooperate with the study treatment
Exclusion Criteria:
- Have used sedative-hypnotic drugs, antipsychotic drugs, opioid analgesics, antihistamines, non-steroidal anti-inflammatory drugs (NSAIDs), central nervous system (CNS) stimulant drugs, or any other medications that alter sleep architecture within the past 30 days
- Have a history of cervical infection, trauma, severe cervical deformity, or prior cervical surgery
- Unable to complete the daily study intervention as required by the trial protocol
- Are participating in another clinical trial, or have participated in other clinical trials with interventions that may interfere with the results of this study
- Have undergone major surgery or general anesthesia within the past 30 days
- Have a history of alcohol abuse
- Are female subjects who are pregnant or lactating, or plan to become pregnant during the study period
- Have severe cognitive impairment, severe psychiatric disorders, epilepsy, or other related neurological disorders
- Have concomitant malignant tumor or severe dysfunction of vital organs
- Have active systemic infection
- Have significant bleeding tendency, or renal failure undergoing regular hemodialysis
- Are deemed unsuitable for the trial by the investigator for any other reason -
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Cuadruplicar
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
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Experimental: Low-Intensity Focused Ultrasound (LIFU) Intervention Arm
Subjects in this arm will receive low-intensity focused ultrasound (LIFU) intervention on the left stellate ganglion.
Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session, once daily for 3-7 consecutive days.
All subjects will receive guideline-concordant standard perioperative cardiovascular care, including surgery and indicated medications.
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The experimental group receives active low-intensity focused ultrasound (LIFU) treatment: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with parameters set as power 2.0W, frequency 1MHz, duty cycle 50%, 30 minutes per session, once daily for 3-7 consecutive days.
All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period.
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Comparador de placebos: Sham Ultrasound Control Arm (Placebo)
Subjects in this arm will receive sham ultrasound intervention with identical operational procedures, device appearance, and parameter settings (no actual energy output) as the intervention arm.
Sessions are once daily for 3-7 consecutive days.
All subjects will receive the same guideline-concordant standard perioperative cardiovascular care as the intervention arm.
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The control group receives sham low-intensity focused ultrasound intervention: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with the same instrument appearance, operation process, parameter setting display (power 2.0W, frequency 1MHz, duty cycle 50%), duration (30 minutes per session, once daily for 3-7 consecutive days) and subject experience as the experimental group, but no actual ultrasound energy is output.
All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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SDNN
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Standard deviation of all normal-to-normal intervals measured by wearable Holter monitor; Unit: ms; Measurement device: wearable Holter monitors.
|
Pre-operative 24 hours and Post-operative 72 hours
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Total sleep duration
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Total sleep time measured by wearable sleep monitor; Unit: hours; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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SDANN
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Standard deviation of the averages of NN intervals in all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
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SDNN Index
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Mean of the standard deviations of all NN intervals for all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
|
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RMSSD
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Root mean square of successive differences between normal heartbeats; Unit: ms; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
|
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pNN50
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Percentage of successive NN intervals that differ by more than 50 ms; Unit: %; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
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LF power
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Low frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
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HF power
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
High frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
|
|
TP
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Total power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
|
Pre-operative 24 hours and Post-operative 72 hours
|
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LF/HF ratio
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Ratio of low frequency to high frequency power; Unit: ratio; Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
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Wakefulness percentage
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Percentage of time awake during sleep period; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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Insomnia percentage
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Percentage of time with insomnia symptoms during sleep period; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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REM sleep percentage
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Percentage of rapid eye movement sleep during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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N1 sleep stage percentage
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Percentage of N1 sleep stage during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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N2 and N3 sleep stages percentage
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Combined percentage of N2 and N3 sleep stages during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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Sleep efficiency
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Ratio of total sleep time to time in bed; Unit: %; Measurement device: Wearable sleep monitor.
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Pre-operative 24 hours and Post-operative 72 hours
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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IL-1β level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Serum IL-1β concentration; Unit: pg/mL.
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Pre-operative 24 hours and Post-operative 72 hours
|
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Norepinephrine (NE) level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Serum norepinephrine concentration; Unit: pg/mL.
|
Pre-operative 24 hours and Post-operative 72 hours
|
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Brain-derived neurotrophic factor (BDNF) level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Serum brain-derived neurotrophic factor concentration; Unit: pg/mL.
|
Pre-operative 24 hours and Post-operative 72 hours
|
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Pittsburgh Sleep Quality Index (PSQI) score
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Subjective sleep quality assessed using the Pittsburgh Sleep Quality Index questionnaire; Unit: Score on a 0-21 scale, where higher scores indicate worse sleep quality; Method of Measurement: Self-administered questionnaire.
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Pre-operative 24 hours and Post-operative 72 hours
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Number of atrial arrhythmias
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Measurement: count of atrial arrhythmia episodes.
Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
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Duration of atrial arrhythmias
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Measurement: Duration of atrial arrhythmia episodes.
Measurement device: wearable Holter monitors.
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Pre-operative 24 hours and Post-operative 72 hours
|
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TNF-α level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Serum TNF-α concentration; Unit: pg/mL.
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Pre-operative 24 hours and Post-operative 72 hours
|
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Neuropeptide Y (NPY) level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
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Serum neuropeptide Y concentration; Unit: pg/mL.
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Pre-operative 24 hours and Post-operative 72 hours
|
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Melatonin level
Periodo de tiempo: Pre-operative 24 hours and Post-operative 72 hours
|
Serum melatonin concentration; Unit: pg/mL.
|
Pre-operative 24 hours and Post-operative 72 hours
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Enfermedades del Sistema Nervioso
- Desordenes mentales
- Procesos Patológicos
- Enfermedades cardíacas
- Arritmias Cardiacas
- Trastornos del sueño y la vigilia
- Trastornos del Sueño Intrínsecos
- Disomnias
- Condiciones Patológicas, Signos y Síntomas
- Enfermedades cardiovasculares
- Fibrilación auricular
- Trastornos de iniciación y mantenimiento del sueño
Otros números de identificación del estudio
Otros números de identificación del estudio
- WDRY2026-K085
- 82570593 (Otro número de subvención/financiamiento: National Natural Science Foundation of China (NSFC))
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
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