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Updated: May 6, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Silent cerebral infarcts associated with cardiac disease and procedures
Mariëlla E C Hassell1, Robin Nijveldt, Yvo B W Roos
1Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
Insights
Silent cerebral infarcts (SCIs) are common in heart disease patients and after cardiac procedures. Recognizing SCIs may improve prevention strategies and reduce neurological risks like stroke and cognitive decline.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Clinically silent cerebral infarcts (SCIs) are frequently observed in patients with cardiac disease.
- SCIs are linked to conditions such as atrial fibrillation, left ventricular thrombus, cardiomyopathy, and patent foramen ovale.
- Post-procedural SCIs occur after various cardiac interventions including catheterization, valve implantation, and surgery.
Purpose of the Study:
- To review the occurrence and clinical significance of SCIs in the context of cardiac disease.
- To discuss diagnostic modalities for identifying SCIs.
- To highlight the association between SCIs and adverse neurological outcomes.
Main Methods:
- Literature review of studies on silent cerebral infarcts.
- Analysis of associations between cardiac conditions/procedures and SCIs.
- Overview of diagnostic techniques for SCIs.
Main Results:
- SCIs are prevalent in individuals with heart disease and following cardiac procedures.
- SCIs are precursors to symptomatic stroke and linked to cognitive decline, dementia, and depression.
- Various cardiac conditions and invasive procedures are associated with increased SCI risk.
Conclusions:
- Increased recognition of SCIs is crucial for understanding their link to cardiac disease and procedures.
- Improved understanding may lead to better prevention therapies and reduced neurological risks.
- Further research into SCIs can enhance patient outcomes and mitigate adverse neurological events.
Abstract:
The occurrence of clinically silent cerebral infarcts (SCIs) in individuals affected by cardiac disease and after invasive cardiac procedures is frequently reported. Indeed, atrial fibrillation, left ventricular thrombus formation, cardiomyopathy, and patent foramen ovale have all been associated with SCIs. Furthermore, postprocedural SCIs have been observed after left cardiac catheterization, transcatheter aortic valve implantation, CABG surgery, pulmonary vein isolation, and closure of patent foramen ovale. Such SCIs are often described as precursors to symptomatic stroke and are associated with cognitive decline, dementia, and depression. Increased recognition of SCIs might advance our understanding of their relationship with heart disease and invasive cardiac procedures, facilitate further improvement of therapies or techniques aimed at preventing their occurrence and, therefore, decrease the risk of adverse neurological outcomes. In this Review, we provide an overview of the occurrence and clinical significance of, and the available diagnostic modalities for, SCIs related to cardiac disease and associated invasive cardiac procedures.
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