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Asymptomatic cerebral infarction (SBI) is usually found in patients with catheterized aortic valve implantation (TAVI) when patients are screened with diffusion-weighted magnetic resonance imaging (DW-MRI).
SBI is associated with sexual cognitive impairment.
, however, their prognosm of TAVI is not yet clear.
recently, a research paper published in Eur Heart J, an authoritative journal in the field of cardiovascular medicine, looked at the incidence and potential risk factors of SBI after (i) TAVI, and (ii) the effects of SBI on cognitive impairment (PCD) after early surgery.
researchers conducted a systematic literature review to determine all the literature that reported SBI rates, such as SBI detected by DW-MRI after TAVI.
researchers evaluated the occurrence of SBI, baseline characteristics, and early PCD through meta-analysis and meta-regression models.
identified 39 related studies involving 2,408 patients.
of the 2,171 patients who received DW-MRI after surgery, 1,601 had at least one new SBI (combined effect of 0.76, 95% CI: 0.72-0.81).
reported a 3% risk of stroke associated with hypochemic neurofuncation deficiency.
, chronic kidney disease, 3-Tesla MRI and pre-expansion were associated with increased SBI risk, according to Meta Regression.
the prevalence of early PCD increased during follow-up, from 16 per cent of 10.0±6.3 days to 26 per cent of 6.1±1.7 months, and a meta-regression suggested an association between the average number of new SBI and PCD rates.
use of cerebral embolism protection devices (CEPDs) appears to reduce the volume of SBI, but does not reduce its overall rate.
, diabetes, kidney disease, and pre-expansion increase the overall risk of SBI.
although a large number of new SBIs appear to have adverse effects on early neurocognitive outcomes, it is clear whether TAVI tests should be extended to low-risk patients in long-term follow-up studies.
use of CAPD did not significantly reduce the occurrence of SBI.