医学
狭窄
心脏病学
脑血流
内科学
海马体
主动脉瓣
主动脉瓣狭窄
脑灌注压
灌注
作者
Satoshi Tsuchiya,Yasuharu Matsumoto,Hideaki Suzuki,Kentaro Takanami,Yoku Kikuchi,Jun Takahashi,Satoshi Miyata,Naoki Tomita,Koji Kumagai,Yasuyuki Taki,Yoshikatsu Saiki,Hiroyuki Arai,Hiroaki Shimokawa
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2020-04-01
卷期号:15 (18): e1580-e1587
被引量:4
标识
DOI:10.4244/eij-d-19-00489
摘要
The aim of this study was to examine the mechanisms of cognitive impairment and reversibility in elderly patients with severe aortic stenosis (AS) after transcatheter aortic valve implantation (TAVI) with special reference to cerebral blood flow (CBF).We examined 15 elderly patients with severe AS (mean age 83.2±4.5 years, 12 female) who underwent TAVI. Before and three months after TAVI, we evaluated cognitive function with the Logical Memory II test (LM II), cardiac output (CO) with echocardiography, and CBF with 99mTc single-photon emission computed tomography (SPECT). LM II score and CO were significantly increased after TAVI compared with baseline (p<0.01 for LM II, p<0.005 for CO). Notably, CBF in the local regions, including that in the right hippocampus, was significantly increased after TAVI (p<0.005 at each voxel). The patients with increased CO after TAVI also showed significantly increased CBF in the right hippocampus compared with those without it (p<0.01). Importantly, CBF in the right hippocampus was positively correlated with LM II scores (p<0.05).These results provide the first evidence that TAVI may improve cognitive functions associated with increased cerebral perfusion especially in the hippocampus in elderly patients with severe AS.
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