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Cardiovascular Effects of Norepinephrine

NCT05761522 · Status: RECRUITING · Type: OBSERVATIONAL · Enrollment: 49

Last updated 2024-08-22

No results posted yet for this study

Summary

Previous studies of our team reported the improvement of myocardial contractility both on hemodynamic parameters (by transpulmonary thermodilution) and morphological (by transthoracic echocardiography: TTE), during the early phase of septic shock (during the first 4 hours management of septic shock).

However, one can wonder about the effect of NAD on myocardial cardiac ouput and contractility beyond the early phase of septic shock, more precisely beyond the first 24 hours. Indeed, while it continues to act on the "stressed" blood volume and the diastolic left ventricular perfusion by increasing the diastolic arterial pressure (DAP), it has been reported in old studies that beyond the early phase, the sensitivity of the β1-adrenergic receptors is altered due to the phenomenon of internalization of these receptors, leading to a reduction of the myocardial response to catecholamines.

The investigators can then wonder whether norepinephrine still exerts a positive effect on myocardial contractility via the increase in DAP, despite an alteration of the β1-adrenergic pathway.

To answer this question, the investigators proposed to evaluate the effects of norepinephrine by TTE on cardiac contractility after the initial phase.

Conditions

  • Septic Shock

Interventions

OTHER

transthoracic echocardiography

* Concerning the main judgment criterion and the secondary judgment criteria: * Left ventricular ejection fraction (LVEF) by the Simpson Biplane method, * Cardiac output and cardiac index by continuity equation (measurement of left ventricular outflow chamber (mm) and sub-aortic time-velocity integral (cm/s)). * Tricuspid Annular Systolic Excursion (TAPSE) (mm) * S wave at the tricuspid ring (cm/s) * Other parameters collected systematically: * Surface of the left ventricle (end-systolic and end-diastolic), * Global strain of the left ventricle * Mitral Annular Plane Systolic Excursion (MAPSE) (mm) * Left ventricular filling pressure (LVRP) (at the mitral annulus, E, A, e', S' waves, E/A ratio, E/e'); * Maximum tricuspid regurgitation velocity (m/s) to estimate systolic pulmonary arterial pressure (PAPs) (mmHg)

Sponsors & Collaborators

  • CHU de Reims

    lead OTHER

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2023-04-21
Primary Completion
2025-03-21
Completion
2025-12-21

Countries

  • France

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05761522 on ClinicalTrials.gov