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PeriOperative Medicine - Metabolic Inflexibility as a Mechanism for Myocardial Injury After Non-Cardiac Surgery
Sponsor: University College, London
Summary
The goal of this observational study is to learn whether metabolic inflexibility, which means reduced ability of the body to switch between using fats and sugars for energy, is associated with myocardial injury after non-cardiac surgery (MINS) in adults undergoing major elective abdominal cancer surgery. The main question it aims to answer is: Does pre-operative metabolic inflexibility predict myocardial injury after non-cardiac surgery (MINS) within the first 72 hours after surgery? Participants will continue with their usual surgical care and pre-planned CPET (which can measure metabolic flexibility). As part of the study, participants will: * Have additional blood samples taken before and after surgery * Have an echocardiogram and, where possible, muscle ultrasound * Wear a wrist-worn activity monitor before surgery * Have routine clinical and surgical information collected from their medical records * Receive a follow-up phone call around 90 days after surgery
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
OBSERVATIONAL
Enrollment
300
Start Date
2026-10-01
Completion Date
2030-10-01
Last Updated
2026-07-14
Healthy Volunteers
No
Conditions
Interventions
Pre-operative Metabolic Inflexibility
Pre-operative metabolic inflexibility will be assessed as an observational exposure using data from routine pre-operative cardiopulmonary exercise testing (CPET). CPET-derived measures of substrate utilisation, including fat and carbohydrate oxidation, will be used to evaluate the participant's ability to switch between energy sources during physiological stress. Additional blood-based metabolic, immune, and cardiac biomarker analyses may be used to further characterise metabolic phenotype. No treatment, procedure, or clinical management will be assigned or altered by the study.