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- Essai clinique NCT07601867
Effect of Dapagliflozin on Right Ventricular-Pulmonary Artery Coupling After Off-Pump Coronary Atery Bypass Grafting (DAPA-RV-CABG)
Effect of Dapagliflozin on Right Ventricular-Pulmonary Artery Coupling After Off-Pump Coronary Artery Bypass Grafting: a Prospective Single-Center Study
Aperçu de l'étude
Statut
Les conditions
Description détaillée
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.
Type d'étude
Inscription (Estimé)
Contacts et emplacements
Coordonnées de l'étude
- Nom: Samson S. Badalyan, MD, PhD
- Numéro de téléphone: +79614972949
- E-mail: sambadalyan@mail.ru
Sauvegarde des contacts de l'étude
- Nom: Syune V. Markosyan, MD.
- Numéro de téléphone: +79633876510
- E-mail: ssm8883@gmail.com
Lieux d'étude
-
-
Stavropol Kray
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Pyatigorsk, Stavropol Kray, Russie, 357500
- Recrutement
- Pyatigorsk City Clinical Hospital Number 1
-
Contact:
- Samson S. Badalyan, MD, PhD
- Numéro de téléphone: +79614972949
- E-mail: sambadalyan@mail.ru
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Méthode d'échantillonnage
Population étudiée
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
|---|
|
Dapagliflozin Group
Patients receiving dapagliflozin 10 mg once daily starting at 1 month after off-pump CABG
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in TAPSE/PASP Ratio
Délai: 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)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in Pulmonary Artery Systolic Pressure (PASP)
Délai: 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)
Délai: 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
Délai: 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)
Délai: 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)
Délai: 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)
Délai: 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)
|
Collaborateurs et enquêteurs
Les enquêteurs
- Chercheur principal: Samson S. Badalyan, MD, PhD, Pyatigorsk City Clinical Hospital Number 1
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- DAPA-RV-CABG (Autre identifiant: ClinicalTrials.gov PRS)
Plan pour les données individuelles des participants (IPD)
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