Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function
Background Left atrial appendage occlusion (LAAO) was associated with a high incidence of procedure‐related silent cerebral embolism (SCE). There are limited data regarding the long‐term cognitive trajectory of patients undergoing LAAO. The aim of our study was to comprehensively assess the acute an...
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037968 |
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| author | Kexin Wang Zhe Wang Caiyi Jin Mingjia Xu Mingfang Li Hailei Liu Zidun Wang Hongwu Chen Weizhu Ju Minglong Chen |
| author_facet | Kexin Wang Zhe Wang Caiyi Jin Mingjia Xu Mingfang Li Hailei Liu Zidun Wang Hongwu Chen Weizhu Ju Minglong Chen |
| author_sort | Kexin Wang |
| collection | DOAJ |
| description | Background Left atrial appendage occlusion (LAAO) was associated with a high incidence of procedure‐related silent cerebral embolism (SCE). There are limited data regarding the long‐term cognitive trajectory of patients undergoing LAAO. The aim of our study was to comprehensively assess the acute and long‐term impact of SCE during and after LAAO. Methods Consecutive patients with atrial fibrillation referred for LAAO from the First Affiliated Hospital with Nanjing Medical University between February 2021 and February 2023 were included. All patients underwent magnetic resonance imaging and cognitive assessments before and within 48 hours after the procedure. These evaluations were also repeated at 45‐day, 3‐month, 6‐month, and 1‐year follow up. Results Out of 75 patients included in the final analysis, 29 (38.7%) patients suffered from new SCE during LAAO. Patients with SCE exhibited a significant decline in cognitive function (Mini‐Mental State Examination) immediately after the procedure (P<0.001), which was not reversible during 1‐year follow‐up (P<0.001). Additionally, with time going on, the gap in cognitive function between patients with and without SCE became wider (SCE × 1 year: B=−4.81 [95% CI, −5.58 to −4.05]; P<0.001). New‐onset SCE was detected in 11 (14.7%) patients during the follow‐up magnetic resonance imaging, which also showed a decline in cognitive function (P=0.004). The results in Montreal Cognitive Assessment scores were consistent with Mini‐Mental State Examination. Conclusions LAAO‐related SCE is associated with a marked impairment in cognitive function immediately after the procedure and is irreversible over a 1‐year follow‐up. New magnetic resonance‐detected SCE during follow‐up after LAAO would also be associated with a decline in cognitive function. |
| format | Article |
| id | doaj-art-9be2ed6051c54c18a90f265b316bad8c |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-9be2ed6051c54c18a90f265b316bad8c2025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.037968Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive FunctionKexin Wang0Zhe Wang1Caiyi Jin2Mingjia Xu3Mingfang Li4Hailei Liu5Zidun Wang6Hongwu Chen7Weizhu Ju8Minglong Chen9Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology Affiliated Hospital 2 of Nantong University Nantong ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDivision of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaBackground Left atrial appendage occlusion (LAAO) was associated with a high incidence of procedure‐related silent cerebral embolism (SCE). There are limited data regarding the long‐term cognitive trajectory of patients undergoing LAAO. The aim of our study was to comprehensively assess the acute and long‐term impact of SCE during and after LAAO. Methods Consecutive patients with atrial fibrillation referred for LAAO from the First Affiliated Hospital with Nanjing Medical University between February 2021 and February 2023 were included. All patients underwent magnetic resonance imaging and cognitive assessments before and within 48 hours after the procedure. These evaluations were also repeated at 45‐day, 3‐month, 6‐month, and 1‐year follow up. Results Out of 75 patients included in the final analysis, 29 (38.7%) patients suffered from new SCE during LAAO. Patients with SCE exhibited a significant decline in cognitive function (Mini‐Mental State Examination) immediately after the procedure (P<0.001), which was not reversible during 1‐year follow‐up (P<0.001). Additionally, with time going on, the gap in cognitive function between patients with and without SCE became wider (SCE × 1 year: B=−4.81 [95% CI, −5.58 to −4.05]; P<0.001). New‐onset SCE was detected in 11 (14.7%) patients during the follow‐up magnetic resonance imaging, which also showed a decline in cognitive function (P=0.004). The results in Montreal Cognitive Assessment scores were consistent with Mini‐Mental State Examination. Conclusions LAAO‐related SCE is associated with a marked impairment in cognitive function immediately after the procedure and is irreversible over a 1‐year follow‐up. New magnetic resonance‐detected SCE during follow‐up after LAAO would also be associated with a decline in cognitive function.https://www.ahajournals.org/doi/10.1161/JAHA.124.037968anticoagulationatrial fibrillationcognitive functionleft atrial appendagesilent cerebral embolism |
| spellingShingle | Kexin Wang Zhe Wang Caiyi Jin Mingjia Xu Mingfang Li Hailei Liu Zidun Wang Hongwu Chen Weizhu Ju Minglong Chen Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease anticoagulation atrial fibrillation cognitive function left atrial appendage silent cerebral embolism |
| title | Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function |
| title_full | Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function |
| title_fullStr | Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function |
| title_full_unstemmed | Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function |
| title_short | Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long‐Term Cognitive Function |
| title_sort | impact of silent cerebral embolism during and after left atrial appendage occlusion on long term cognitive function |
| topic | anticoagulation atrial fibrillation cognitive function left atrial appendage silent cerebral embolism |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037968 |
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