New Cerebral Microbleeds After Catheter-Based Structural Heart Interventions: An Exploratory Analysis
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New Cerebral Microbleeds After Catheter-Based Structural Heart Interventions: An Exploratory Analysis. / Braemswig, Tim Bastian; Kusserow, Madeleine; Bellmann, Barbara; Beckhoff, Frederik; Reinthaler, Markus; von Rennenberg, Regina; Erdur, Hebun; Scheitz, Jan F; Galinovic, Ivana; Villringer, Kersten; Leistner, David M; Audebert, Heinrich J; Endres, Matthias; Landmesser, Ulf; Haeusler, Karl Georg; Fiebach, Jochen B; Lauten, Alexander; Rillig, Andreas; Nolte, Christian H.
in: J AM HEART ASSOC, Jahrgang 12, Nr. 3, 07.02.2023, S. e8189.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - New Cerebral Microbleeds After Catheter-Based Structural Heart Interventions: An Exploratory Analysis
AU - Braemswig, Tim Bastian
AU - Kusserow, Madeleine
AU - Bellmann, Barbara
AU - Beckhoff, Frederik
AU - Reinthaler, Markus
AU - von Rennenberg, Regina
AU - Erdur, Hebun
AU - Scheitz, Jan F
AU - Galinovic, Ivana
AU - Villringer, Kersten
AU - Leistner, David M
AU - Audebert, Heinrich J
AU - Endres, Matthias
AU - Landmesser, Ulf
AU - Haeusler, Karl Georg
AU - Fiebach, Jochen B
AU - Lauten, Alexander
AU - Rillig, Andreas
AU - Nolte, Christian H
PY - 2023/2/7
Y1 - 2023/2/7
N2 - 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).
AB - 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).
KW - Aged
KW - Female
KW - Humans
KW - Male
KW - Cardiac Surgical Procedures/adverse effects
KW - Catheters/adverse effects
KW - Cerebral Hemorrhage/diagnostic imaging
KW - Magnetic Resonance Imaging
KW - Mitral Valve Insufficiency/diagnostic imaging
KW - Prospective Studies
KW - Treatment Outcome
U2 - 10.1161/JAHA.122.027284
DO - 10.1161/JAHA.122.027284
M3 - SCORING: Journal article
C2 - 36734351
VL - 12
SP - e8189
JO - J AM HEART ASSOC
JF - J AM HEART ASSOC
SN - 2047-9980
IS - 3
ER -
