Home Bratislava Medical Journal 2023 Bratislava Medical Journal Vol.124, No.9, p.639–646, 2023

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

Impact factor 1.5

 

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Bratislava Medical Journal Vol.124, No.9, p.639–646, 2023

Title: Cognitive changes associated with cerebral emboli during coronary intervention
Author: Dasa VISZLAYOVA, David SKOLOUDIK, Miroslav BROZMAN, Katerina LANGOVA, Roman HERZIG, Martin VALIS, Peter KURRAY, Lukas PATROVIC, Silvia KIRALOVA

Abstract: OBJECTIVE: To investigate factors influencing the frequency and type of microembolic signals (MES) detected using transcranial Doppler (TCD) in patients undergoing elective coronary intervention, and to correlate MES with silent stroke detected using magnetic resonance imaging (MRI) and cognitive dysfunction.
METHODS: The subset study of a randomized clinical trial was conducted on 70 patients (58 males; mean age 59.9 ± 8.4 years) who underwent bilateral TCD monitoring of middle cerebral arteries (MCAs) during elective coronary interventions. Neurologic examination and brain MRI were performed prior to, and 24 h post‑intervention. Cognitive function tests were performed prior to, and on day 30 post‑intervention.
RESULTS: The incidence of detected MES was 94.3 %. Eighteen (25.7 %) patients had new clinically asymptomatic ischemic lesions on MRI. The number of solid MES negatively correlated with changes in revised Addenbrooke’s Cognitive Examination test (ACE-R) and, the number of solid MES and combinations of solid and gaseous MES negatively correlated with changes in Mini Mental‑State Examination (MMSE) conducted on day 30 after the intervention (p < 0.05 in all cases).
CONCLUSION: Cardiac catheterization was associated with a high risk of cerebral embolism in our patients. A higher number of solid MES and combinations of solid and gaseous MES was associated with the deterioration in cognitive tests (Tab. 5, Fig. 3, Ref. 30).

Keywords: microembolic signals, transcranial Doppler, coronary intervention, silent cerebral infarction, cognitive changes
Published online: 04-Jul-2023
Year: 2023, Volume: 124, Issue: 9 Page From: 639, Page To: 646
doi:10.4149/BLL_2023_099


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