Serial neurocognitive changes following transcatheter aortic valve replacement: comparison between low and...

Area of Science:

• Cardiology
• Neurology
• Geriatrics

Background:

• Neurocognitive trajectory data post-transcatheter aortic valve replacement (TAVR) for low versus intermediate-high risk patients is lacking.
• Understanding cognitive changes after TAVR is crucial for patient selection and management.

Purpose of the Study:

• To evaluate serial neurocognitive changes up to one year following TAVR.
• To compare these changes between low and intermediate-high risk patient groups and the overall cohort.

Main Methods:

• Prospective study involving neurological and cognitive assessments (NIHSS, Barthel Index, MMSE, ADAS-cog, Color Trail Test, verbal fluency).
• Assessments were conducted at baseline, 3 months, and 1 year post-TAVR.
• Patients were stratified into low (<4% STS score) and intermediate-high (≥4% STS score) risk groups.

Main Results:

• Overall cohort showed persistent improvement in global cognitive tests (MMSE, ADAS-cog) and psychomotor speed up to one year.
• Intermediate-high risk patients had worse baseline cognition but showed slight improvements in general neurological function and a higher proportion of cognitive improvement.
• Low-risk patients demonstrated significant and persistent improvement in executive functions (Color Trail Tests, verbal fluency).

Conclusions:

• TAVR is linked to sustained global cognitive enhancement and improved attention/psychomotor speed up to one year.
• Executive function benefits post-TAVR are predominantly noted in the low-risk patient group.