Coronary Anatomy and Dynamic Exercise Testing

  • Research type

    Research Study

  • Full title

    Comparison of computed tomography (CT) coronary angiogram and Cardiopulmonary Exercise Tests in patients being evaluated for major surgery

  • IRAS ID

    137525

  • Contact name

    Gary Minto

  • Contact email

    gary.minto@nhs.net

  • Sponsor organisation

    R&D , Plymouth Hospitals NHS Trust

  • Duration of Study in the UK

    2 years, 6 months, 2 days

  • Research summary

    Preoperative assessment before major surgery aims to identify patients who are at high risk of complications and death so that we can focus resources on them. Categorisation of risk is based mostly on patients` heart function. A theory is that heart disease to central to the development of complications because the heart is unable to deliver pump sufficient oxygenated blood to help the healing process .
    Patients with coronary artery disease ( narrowings in the blood vessels through which the heart supplies itself with oxygen ) may be at additional risk .
    We do not know whether all the patients at high risk have abnormalities of heart function or coronary artery disease that could be identified before surgery.
    This study uses two preoperative tests to explore the heart structure (CT Coronary Angiography, CTCA ) and function (Cardiopulmonary Exercise Testing, CPET ) .
    CPET is a bicycle exercise test already part of routine preoperative assessment. Patients who do badly at this are more likely to suffer complications after major operations.
    CTCA has previously not been routinely done preoperatively since it involved a high radiation CT scan of the heart. New technology allows us to perform CTCA with a very much lower radiation dose – and since many patients being assessed for surgery already have CT scans of their chests before an operation ( for example to check for cancer spread) , we could now perform CTCA during those routine scans.
    We propose to do both tests in the same patients to see whether either of them provides important information that the other test does not .
    For a sub-study, we want to gather preliminary data to explore whether using both tests together helps predict which patients get complications after surgery or are likely to die or have disease recurrence within a year.

  • REC name

    South West - Cornwall & Plymouth Research Ethics Committee

  • REC reference

    16/SW/0040

  • Date of REC Opinion

    8 Apr 2016

  • REC opinion

    Further Information Favourable Opinion