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Sökning: onr:"swepub:oai:prod.swepub.kib.ki.se:151082698" > Predictors and neur...

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FältnamnIndikatorerMetadata
00003424naa a2200397 4500
001oai:prod.swepub.kib.ki.se:151082698
003SwePub
008240913s2022 | |||||||||||000 ||eng|
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1510826982 URI
0247 a https://doi.org/10.3389/fcvm.2022.9519432 DOI
040 a (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Suhai, FI4 aut
2451 0a Predictors and neurological consequences of periprocedural cerebrovascular events following transcatheter aortic valve implantation with self-expanding valves
264 c 2022-10-05
264 1b Frontiers Media SA,c 2022
520 a To evaluate the patient- and procedure-related predictors of transcatheter aortic-valve implantation (TAVI)-associated ischemic brain lesions and to assess the effect of silent cerebral ischemic lesions (SCIL) on neurocognitive function.Methods and resultsWe investigated 113 consecutive patients with severe aortic stenosis who underwent brain magnetic resonance imaging (MRI) within a week following TAVI. To assess periprocedural cerebral ischemic lesions, diffusion-weighted MRI was utilized. We used multivariate linear regression to identify the independent predictors of TAVI-related ischemic lesion volume (ILV) and periprocedural stroke. Neurocognitive evaluation was performed before and following TAVI at 6-month and one-year follow-up. Following TAVI, a total of 944 new cerebral ischemic lesions were detected in 104 patients (92%). The median ILV was 257 μl (interquartile range [IQR]:97.1–718.8μl) with a median lesion number of 6/patient [IQR:2–10]. The majority of ischemic lesions were clinically silent (95%), while 5% of the lesions induced a stroke, which was confirmed by MRI. Predilatation (β = 1.13[95%CI:0.32–1.93], p = 0.01) and the number of valve positioning attempts during implantation (β = 0.28[95%CI:0.06–0.50], p = 0.02) increased the log-transformed total ILV. Predilatation (OR = 12.04[95%CI:1.46–99.07], p = 0.02) and alternative access routes (OR = 7.84[95%CI:1.01–61.07], p = 0.02) were associated with stroke after adjustments for comorbidities and periprocedural factors. The presence of SCILs were not associated with a change in neurocognitive function that remained stable during the one-year follow-up.ConclusionWhile periprocedural ischemic lesions are frequent, most of them are clinically silent and might not impact the patients' neurocognitive function. The number of valve positioning attempts, predilatation, and alternative access routes should be taken into consideration during TAVI to reduce the ILV and risk for stroke.
7001 a Varga, A4 aut
7001 a Szilveszter, B4 aut
7001 a Nagy-Vecsey, M4 aut
7001 a Apor, A4 aut
7001 a Nagy, AI4 aut
7001 a Kolossvary, M4 aut
7001 a Karady, J4 aut
7001 a Bartykowszki, A4 aut
7001 a Molnar, L4 aut
7001 a Jermendy, AL4 aut
7001 a Panajotu, A4 aut
7001 a Maurovich-Horvat, P4 aut
7001 a Merkely, B4 aut
7730 t Frontiers in cardiovascular medicined : Frontiers Media SAg 9, s. 951943-q 9<951943-x 2297-055X
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:151082698
8564 8u https://doi.org/10.3389/fcvm.2022.951943

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