Universität zu Köln

Doerner, Jonas, Kupczyk, Patrick A., Wilsing, Marius, Luetkens, Julian A., Storm, Klaus, Fimmers, Rolf, Hickethier, Tilman, Eichhorn, Lars ORCID: 0000-0002-9769-0639, Naehle, Claas P., Schild, Hans H., Werner, Nikos, Nickenig, Georg and Ghanem, Alexander (2018). Cerebral white matter lesion burden is associated with the degree of aortic valve calcification and predicts peri-procedural cerebrovascular events in patients undergoing transcatheter aortic valve implantation (TAVI). Catheter. Cardiovasc. Interv., 91 (4). S. 774 - 783. HOBOKEN: WILEY. ISSN 1522-726X

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Abstract

ObjectivesTo investigate the impact of aortic valve calcification and brain morphology on acute peri-procedural cerebrovascular events (CVEs) in patients undergoing transcatheter aortic valve implantation (TAVI). BackgroundAortic valve calcification and stenosis can be assessed with echocardiography. Cerebral magnetic resonance imaging (MRI) depicts and quantifies morphological signs of hypoperfusion and vascular embolism, which is of special interest in patients with severe aortic stenosis. Furthermore, subjects who undergo TAVI are prone to suffer of clinically silent peri-procedural CVEs. MethodsA total of 119 patients referred to TAVI were investigated for aortic valve calcification using trans-esophageal echocardiography. Cerebral MRI prior to and immediate after implantation was performed in all patients using a dedicated scan protocol. Prior to TAVI, brain morphology was characterized. Post TAVI, brains were investigated for the onset of acute peri-procedural CVEs using diffusion weighted imaging (DWI). ResultsSeventy-eight patients (65.5%) revealed acute peri-procedural CVEs on MRI after TAVI with a favor of the left hemisphere (57.5%). The degree of valve calcification was associated with peri-procedural CVEs. Patients with a high WML burden had an increased risk for CVEs ((OR) 2.36 (95% CI: 1.09-5.15; P=0.037)), especially when distributed periventricular ((OR: 3.27; 95% CI: 1.47-7.26; P=0.0038)). ConclusionIn patients undergoing TAVI, the degree of aortic valve calcification and periventricular WML burden were correlated with acute peri-procedural CVEs. Future studies are needed to evaluate their independent value for the long-term clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doerner, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kupczyk, Patrick A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wilsing, Marius UNSPECIFIED UNSPECIFIED UNSPECIFIED Luetkens, Julian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Storm, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Fimmers, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Hickethier, Tilman UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorn, Lars UNSPECIFIED orcid.org/0000-0002-9769-0639 UNSPECIFIED Naehle, Claas P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schild, Hans H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Nikos UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Ghanem, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-194512
DOI:	10.1002/ccd.27122
Journal or Publication Title:	Catheter. Cardiovasc. Interv.
Volume:	91
Number:	4
Page Range:	S. 774 - 783
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1522-726X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ARTERIAL TERRITORIES; ROTTERDAM SCAN; HUMAN BRAIN; COGNITIVE FUNCTION; PROGNOSTIC VALUE; RISK PATIENTS; STENOSIS; REPLACEMENT; STROKE; SILENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19451