X-MINS

  • Research type

    Research Study

  • Full title

    Role of parasympathetic dysfunction in perioperative cardiac injury.

  • IRAS ID

    164406

  • Contact name

    Robert Stephens

  • Contact email

    robert.stephens1@nhs.net

  • Sponsor organisation

    University College London Hospitals

  • Duration of Study in the UK

    2 years, 0 months, 0 days

  • Research summary

    Injury to the heart is commonplace during major surgery. This dramatically increases the risk of postoperative death and other complications, and delays recovery. A better understanding of the mechanisms contributing to heart injury after major surgery is necessary to develop new strategies to improve outcomes.

    The heart and other organs in the body are protected by specialized nerves that constantly monitor our health. These nerves feedback signals to the brain that, in response to organ injury, help reduce inflammation. The vagus nerve is one such protective nerve that is particularly effective at protecting the heart. This may then result in damage to the heart tissue, resulting in postoperative complications. In some patients, vagus nerve function may be – or become- impaired – particularly during stressful situations such as surgery and anaesthesia. Through exercise and special tests performed preoperatively, vagus nerve function can be identified as working adequately.
    We will test the function of the vagus nerve by activating a special nerve reflex, which involves three five minute periods of inflating a blood pressure cuff and measuring heart rate. Via an IV drip that patients will receive as part of their routine anaesthetic, we will take a tablespoon of blood before and after this blood pressure cuff test to see whether white blood cells (and/or muscle)show evidence of being protected by the vagus nerve. As the genetic code for damaged heart tissue is leaked into the blood after major operations, we will also determine whether this code is different in patients with impaired nerve function by analysing blood samples collected over the first 3 days postoperatively.

  • REC name

    London - Stanmore Research Ethics Committee

  • REC reference

    16/LO/0635

  • Date of REC Opinion

    3 Jun 2016

  • REC opinion

    Further Information Favourable Opinion