New Cerebral Microbleeds After Catheter‐Based Structural Heart Interventions: An Exploratory Analysis-Reference-Cited by-同舟云学术

New Cerebral Microbleeds After Catheter‐Based Structural Heart Interventions: An Exploratory Analysis

Published:2023-02-07 Issue:3 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Braemswig Tim Bastian¹²³⁴^ORCID,Kusserow Madeleine⁵⁶,Bellmann Barbara⁷⁸^ORCID,Beckhoff Frederik⁸^ORCID,Reinthaler Markus⁸⁹¹⁰,von Rennenberg Regina¹³¹¹^ORCID,Erdur Hebun¹³^ORCID,Scheitz Jan F.¹²³⁴^ORCID,Galinovic Ivana³^ORCID,Villringer Kersten³^ORCID,Leistner David M.²⁴⁸¹²¹³^ORCID,Audebert Heinrich J.¹³^ORCID,Endres Matthias¹³⁴¹¹¹⁴^ORCID,Landmesser Ulf²⁴⁸¹⁰^ORCID,Haeusler Karl Georg¹⁵^ORCID,Fiebach Jochen B.³^ORCID,Lauten Alexander⁸¹⁶,Rillig Andreas⁸¹⁷^ORCID,Nolte Christian H.¹²³⁴¹¹^ORCID

Affiliation:

1. Klinik und Hochschulambulanz für Neurologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

2. Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin Berlin Germany

3. Center for Stroke Research Berlin (CSB) Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

4. German Centre for Cardiovascular Research (DZHK), partner site Berlin Berlin Germany

5. Klinik für Innere Medizin Bundeswehrkrankenhaus Berlin Berlin Germany

6. Charité – Universitätsmedizin Berlin corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

7. MEDIAN Klinik AGZ Düsseldorf Düsseldorf Germany

8. Department of Cardiology Campus Benjamin Franklin Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

9. Institute of Active Polymers and Berlin‐Brandenburg Center for Regenerative Therapies Helmholtz‐Zentrum Hereon Teltow Germany

10. Deutsches Herzzentrum der Charité, Klinik für Kardiologie Angiologie und Intensivmedizin Berlin Germany

11. German Center for Neurodegenerative Diseases (DZNE), partner site Berlin Berlin Germany

12. Department of Medicine III, Cardiology Goethe University Frankfurt am Main Germany

13. German Centre for Cardiovascular Research (DZHK), partner site Rhine‐Main Frankfurt Germany

14. ExcellenceCluster NeuroCure Berlin Germany

15. Department of Neurology Universitätsklinikum Würzburg Würzburg Germany

16. Department of General and Interventional Cardiology Helios Klinikum Erfurt Erfurt Germany

17. Universitäres Herz‐ und Gefässzentrum Hamburg‐Eppendorf Hamburg Germany

Abstract

Background Cerebral microbleeds (CMBs) are increasingly recognized as “covert” brain lesions indicating increased risk of future neurological events. However, data on CMBs in patients undergoing catheter‐based structural heart interventions are scarce. Therefore, we assessed occurrence and predictors of new CMBs in patients undergoing catheter‐based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Methods and Results We conducted an exploratory analysis using data derived from 2 prospective, observational studies. Eligible patients underwent cerebral magnetic resonance imaging (3 Tesla) examinations and cognitive tests (using the Montreal Cognitive Assessment) before and after catheter‐based left atrial appendage closure and percutaneous mitral valve repair. Forty‐seven patients (53% men; median age, 77 years) were included. New CMBs occurred in 17 of 47 patients (36%) following catheter‐based structural heart interventions. Occurrences of new CMBs did not differ significantly between patients undergoing catheter‐based left atrial appendage closure and percutaneous mitral valve repair (7/25 versus 10/22; P =0.348). In univariable analysis, longer procedure time was significantly associated with new CMBs. Adjustment for heparin attenuated this association (adjusted odds ratio [per 30 minutes]: 1.77 [95% CI, 0.92–3.83]; P =0.090). Conclusions New CMBs occur in approximately one‐third of patients after catheter‐based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Our data suggest that longer duration of the procedure may be a risk factor for new CMBs. Future studies in larger populations are needed to further investigate their clinical relevance. Clinical Trial Registration German Clinical Trials Register: DRKS00010300 ( https://drks.de/search/en/trial/DRKS00010300 ); ClinicalTrials.gov : NCT03104556 ( https://clinicaltrials.gov/ct2/show/NCT03104556?term=NCT03104556&draw=2&rank=1 ).

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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