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Solid cerebral microemboli and cerebrovascular symptoms in patients with prosthetic heart valves

Mona Skjelland1, Annika Michelsen, Frank Brosstad

  • 1Department of Neurology, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Oslo, Norway. mona.skjelland@rikshospitalet.no

Stroke
|February 23, 2008
PubMed

Insights

Solid cerebral microemboli detected via transcranial Doppler ultrasonography in mechanical heart valve patients correlate with cerebrovascular symptoms. This finding may help predict ischemic stroke risk in this population.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Medical Imaging

Background:

  • Cerebral microemboli are frequently detected in patients with mechanical heart valves.
  • The clinical significance of these microemboli remains unclear.
  • Prosthetic heart valves, both mechanical and biologic, are used to treat valvular heart disease.

Purpose of the Study:

  • To determine the frequency and composition of cerebral microemboli in prosthetic heart valve patients.
  • To correlate microemboli findings with cerebrovascular symptoms.
  • To investigate the relationship between microemboli, inflammation, and coagulation parameters.

Main Methods:

  • Seventy-six patients with 81 prosthetic heart valves underwent multifrequency transcranial Doppler ultrasonography one year post-valve replacement.
  • Cerebrovascular events were recorded by a neurologist.
  • Inflammation and coagulation markers were measured using immunoassays.

Main Results:

  • Microemboli were exclusively detected in mechanical heart valve patients (56%).
  • Solid microemboli were identified in 34% of mechanical heart valve patients.
  • The presence of solid microemboli was significantly associated with cerebrovascular symptoms (P=0.026) and elevated monocyte chemotactic protein-1 levels (P=0.014).

Conclusions:

  • Solid cerebral microemboli are detectable in a significant portion of mechanical heart valve patients.
  • The detection of solid microemboli is linked to cerebrovascular events.
  • Detecting solid microemboli may aid in predicting ischemic stroke risk in mechanical heart valve recipients.
Abstract

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