The Role of Left Ventricular Outflow Tract (LVOT) Velocity-time Integral (VTI) and Respiratory Variability at Peak Rate (Vpeak) in Predicting Hypotension After General Anesthesia Induction

NCT07121699 | Not Yet Recruiting DMC

• 1 other identifier: 2025-08
• Study Type: observational
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

Preoperatively, patients will undergo transthoracic echocardiography measurements approximately 15-30 minutes before induction. TTE will be performed on all patients by an experienced observer; the echocardiography device will be equipped with an S4-2 transducer (4-2 MHz frequency range) in the left lateral decubitus position. VTI and Vpeak values of the LVOT were measured from manually drawn contours using pulsatile wave Doppler technique in the apical five-chamber view. The Doppler beam was aligned with the aortic blood flow, and the signal was captured at an appropriate angle (\<20°). The maximum (VTImax) and minimum (VTImin) VTI, as well as the maximum (Vpeakmax) and minimum (Vpeakmin) Vpeak values, were determined over three respiratory cycles. ΔVTI was calculated with the following formula: ΔVTI = \[2 × (VTImax - VTImin) / (VTImax + VTImin)\] × 100%. ΔVpeak was calculated with the following formula: ΔVpeak = \[2 × (Vpeakmax - Vpeakmin) / (Vpeakmax + Vpeakmin)\] × 100%. These parameters were analyzed to evaluate the hemodynamic status of patients and estimate fluid responsiveness. Patients with a 30% decrease from baseline in SBP and a decrease in MAP below 60 mmHg in the first 10 minutes after anesthesia induction were considered to have hypotension. Patients were divided into two groups: "with" and "without" hypotension.

Conditions

Hypotension on Induction

Keywords

respiratory variability in peak velocity (Vpeak); left ventricular outflow tract (LVOT) velocity-time integral (VTI); general anesthesia; hypotension

Outcome Measures

Primary Outcomes (1)

• lvot-vtı

  The relationship between hypotension following induction of general anesthesia and respiratory variability in left ventricular outflow tract VTI peak velocity (Vpeak variability).

  1 hour

Secondary Outcomes (1)

• lv echo

  1 hour

Study Arms (2)

with hypotension

Patients with a 30% decrease in SBP from baseline and a decrease in MAP below 65 mmHg in the first 10 minutes after anesthesia induction will be considered to have hypotension.

Drug: Inotrope

none hypotension

Patients with a 30% decrease in SBP from baseline and a decrease in MAP below 65 mmHg in the first 10 minutes after anesthesia induction will be considered to have hypotension.

Interventions

Inotrope DRUG

Hypotensive attacks with MAP below 55 mmHg or prolonged duration (2 minutes or more) will be treated with ephedrine 0.1 mg/kg.

with hypotension

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

This study will be conducted on hemodynamically stable patients aged between 18 and 75 years, with an American Society of Anesthesiologists (ASA) physical status classification of I-III, who are scheduled for elective surgery and will undergo general anesthesia.

You may qualify if:

• years
• ASA Physical Status 1-3;
• Patients scheduled for general anesthesia

You may not qualify if:

• Patient is pregnant
• Post-cardiac surgery
• Severe pulmonary hypertension
• Severe valvular disease
• Hypertrophic or dilated cardiomyopathy
• Presence of acute myocardial infarction
• Patients with severe visual or hearing impairment/impairment
• ASA physical status IV or V
• Ischemic heart disease, conduction disturbance
• History of long-term use of certain medications (β-blockers, angiotensin-converting enzyme inhibitors, analgesics, sedatives, or tricyclic antidepressants)

Sponsors & Collaborators

• Aydin Adnan Menderes University: lead

MeSH Terms

Conditions

Hypotension

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: asst. prof.dr

Study Record Dates

• First Submitted: August 7, 2025
• First Posted: August 13, 2025
• Study Start: August 20, 2025
• Primary Completion: August 20, 2025
• Study Completion: September 1, 2025
• Last Updated: August 13, 2025

Record last verified: 2025-08