Echocardiographic Measurement of Myocardial Work (MYOLOAD)

Centre Hospitalier Universitaire de Nice

Status: Not yet enrolling

Conditions: Cardiovascular Physiological Phenomena; Intensive Care Unit Syndrome

Treatments: Other: Fluid administration; Other: Norepinephrine administration or increase in norepinephrine dosage

Study type: Interventional

Funder types: Other

Identifiers

NCT06422481

24-PP-04

Details and patient eligibility

About

Echocardiography is recommended for the hemodynamic management of patients with shock. Recently, a new echocardiographic method has been proposed that provides a non-invasive measurement of myocardial work incorporating different components, namely total myocardial work (GWI), constructive myocardial work (GCW), lost myocardial work (GWW) and effective myocardial work (GWE). Echocardiographic measurement of myocardial work takes into account both myocardial deformation and left ventricular afterload (estimated by measuring systolic blood pressure) and, unlike the measurement of left ventricular ejection fraction and global longitudinal strain, could be less dependent on cardiac load conditions, particularly left ventricular afterload. To date, non-invasive measurement of myocardial work has never been validated in critically ill patients, and no study has assessed the effects of different therapies (fluids administration, administration of norepinephrine) on the different components of myocardial work in patients admitted to intensive care unit.

Enrollment: 110 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Indication to fluid administration left to the discretion of the attending physician
• Indication to norepinephrine administration or increase in norepinephrine dosage left to the discretion of the attending physician.

Exclusion criteria

• Patients under protection.
• Patients with do not ressuscitate order.
• Patients with severe left-side or right-side valvulopathy.
• Patients with atrial fibrillation.
• Patients with ventricular aneuvrysm or severe regional wall motion abnormalities.
• Patients with a pacemaker.
• Patients' objections to the collection of their health data.

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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110 participants in 2 patient groups

Fluids

Experimental group

Treatment:

Other: Fluid administration

Norepinephrine

Experimental group

Treatment:

Other: Norepinephrine administration or increase in norepinephrine dosage