在左心室尾封闭期间和之后静音脑栓塞对长期认知功能的影响
Kexin Wang1, Zhe Wang2, Caiyi Jin1
1Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China.
Journal of the American Heart Association
|February 3, 2025
概括
左心房附属体封闭 (LAAO) 可能导致静音脑栓塞 (SCE),导致不可逆转的认知能力下降. 随访期间的新SCE也会损害认知功能,这凸显了LAAO程序后需要进行监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 左心房附属体封闭 (LAAO) 与沉默脑栓塞 (SCE) 的高发病率有关.
- 关于LAAO手术后的长期认知影响的数据有限.
- 这项研究旨在评估SCE在LAAO患者的急性和长期认知影响.
研究的目的:
- 评估沉默性脑栓塞 (SCE) 在接受左心房尾闭塞 (LAAO) 的患者的即时和长期认知后果.
- 研究随访期间新的SCE事件与认知功能之间的关系.
- 为了确定LAAO相关SCE后认知衰退的可逆性.
主要方法:
- 包括75名心房的患者接受LAAO治疗.
- 磁共振成像和认知评估 (MMSE,MoCA) 进行了手术前,手术后48小时内,以及45天,3个月,6个月和1年的随访.
- 随着时间的推移,分析了认知功能和新SCE的发生率.
主要成果:
- 29%的患者在LAAO期间出现了新的SCE,显示出显著的即时认知衰退 (MMSE,P<0.001),在1年后是不可逆转的.
- 在1年内,SCE和无SCE患者之间的认知功能差距扩大 (P<0.001).
- 在随访期间,14.7%的患者出现了新的SCE,与认知能力下降有关 (P=0.004).
结论:
- 与LAAO相关的SCE在手术后立即导致显著的,不可逆转的认知障碍,并在1年后进行随访.
- 在LAAO后的随访期间检测到的新SCE也与认知能力下降有关.
- 这些发现强调了监测LAAO后患者的认知功能的重要性.
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