冠状动脉介入治疗期间与脑栓塞相关的认知改变。

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Dasa Viszlayova, David Skoloudik, Miroslav Brozman, Katerina Langova, Roman Herzig, Martin Valis, Peter Kurray, Lukas Patrovic, Silvia Kiralova
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引用次数: 0

摘要

目的:探讨选择性冠状动脉介入治疗患者经颅多普勒(TCD)检测微栓塞信号(MES)频率和类型的影响因素,并探讨MES与磁共振成像(MRI)检测的无症状脑卒中和认知功能障碍的相关性。方法:对70例患者进行随机临床试验的亚组研究(男性58例;平均年龄59.9±8.4岁),在选择性冠状动脉介入治疗期间接受双侧大脑中动脉TCD监测。干预前和干预后24小时分别进行神经系统检查和脑MRI。在干预前和干预后第30天分别进行认知功能测试。结果:检测到MES的发生率为94.3%。18例(25.7%)患者MRI上出现新的临床无症状缺血性病变。固体MES数量与修正adenbrooke认知检查(ACE-R)的变化呈负相关,固体MES数量和固体与气体MES组合与干预后第30天进行的迷你精神状态检查(MMSE)的变化呈负相关(所有病例均p < 0.05)。结论:心导管插入术与脑栓塞的高风险相关。较高数量的固体MES以及固体和气体MES的组合与认知测试中的恶化有关(表5,图3,参考文献30)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive changes associated with cerebral emboli during coronary intervention.

Objective: To investigate factors influencing the frequency and type of microembolic signals (MES) detected using transcranial Doppler (TCD) in patients undergoing elective coronary intervention, and to correlate MES with silent stroke detected using magnetic resonance imaging (MRI) and cognitive dysfunction.

Methods: The subset study of a randomized clinical trial was conducted on 70 patients (58 males; mean age 59.9 ± 8.4 years) who underwent bilateral TCD monitoring of middle cerebral arteries (MCAs) during elective coronary interventions. Neurologic examination and brain MRI were performed prior to, and 24 h post‑intervention. Cognitive function tests were performed prior to, and on day 30 post‑intervention.

Results: The incidence of detected MES was 94.3 %. Eighteen (25.7 %) patients had new clinically asymptomatic ischemic lesions on MRI. The number of solid MES negatively correlated with changes in revised Addenbrooke's Cognitive Examination test (ACE-R) and, the number of solid MES and combinations of solid and gaseous MES negatively correlated with changes in Mini Mental‑State Examination (MMSE) conducted on day 30 after the intervention (p < 0.05 in all cases).

Conclusion: Cardiac catheterization was associated with a high risk of cerebral embolism in our patients. A higher number of solid MES and combinations of solid and gaseous MES was associated with the deterioration in cognitive tests (Tab. 5, Fig. 3, Ref. 30).

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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
185
审稿时长
3-8 weeks
期刊介绍: The international biomedical journal - Bratislava Medical Journal – Bratislavske lekarske listy (Bratisl Lek Listy/Bratisl Med J) publishes peer-reviewed articles on all aspects of biomedical sciences, including experimental investigations with clear clinical relevance, original clinical studies and review articles.
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