Evolution of Cognitive Function After Transcatheter Aortic Valve Implantation.

Schoenenberger, Andreas W; Zuber, Chantal; Moser, André; Zwahlen, Marcel; Wenaweser, Peter; Windecker, Stephan; Carrel, Thierry; Stuck, Andreas E; Stortecky, Stefan (2016). Evolution of Cognitive Function After Transcatheter Aortic Valve Implantation. Circulation: Cardiovascular interventions, 9(10), e003590. Lippincott Williams & Wilkins 10.1161/CIRCINTERVENTIONS.116.003590

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BACKGROUND This study aimed to assess the evolution of cognitive function after transcatheter aortic valve implantation (TAVI). Previous smaller studies reported conflicting results on the evolution of cognitive function after TAVI. METHODS AND RESULTS In this prospective cohort, cognitive function was measured in 229 patients ≥70 years using the Mini Mental State Examination before and 6 months after TAVI. Cognitive deterioration or improvement was defined as change of ≥3 points decrease or increase in the Mini Mental State Examination score between baseline and follow-up. Cognitive deterioration was found in 29 patients (12.7%). Predictive analysis using logistic regression did not identify any statistically significant predictor of cognitive deterioration. A review of individual medical records in 8 patients with a major Mini Mental State Examination score decrease of ≥5 points revealed specific causes in 6 cases (postinterventional delirium in 2; postinterventional stroke, progressive renal failure, progressive heart failure, or combination of preexisting cerebrovascular disease and mild cognitive impairment in 1 each). Among 48 patients with impaired baseline cognition (Mini Mental State Examination score <26 points), 18 patients (37.5%) cognitively improved. The preinterventional aortic valve area was lower in patients who cognitively improved (median aortic valve area 0.60 cm(2)) as compared with patients who did not improve (median aortic valve area 0.70 cm(2); P=0.01). CONCLUSIONS This is the first study providing evidence that TAVI results in cognitive improvement among patients who had impaired preprocedural cognitive function, possibly related to hemodynamic improvement in patients with severe aortic stenosis. Our results confirm that some patients experience cognitive deterioration after TAVI.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic > Geriatric Clinic Inselspital
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Schoenenberger, Andreas; Moser, André; Zwahlen, Marcel; Wenaweser, Peter Martin; Windecker, Stephan; Carrel, Thierry; Stuck, Andreas and Stortecky, Stefan

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1941-7632

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

29 Sep 2016 10:57

Last Modified:

10 Sep 2017 13:44

Publisher DOI:

10.1161/CIRCINTERVENTIONS.116.003590

PubMed ID:

27655999

Uncontrolled Keywords:

aortic valve stenosis; cognition; geriatric assessment; heart failure; transcatheter aortic valve replacement

BORIS DOI:

10.7892/boris.88894

URI:

https://boris.unibe.ch/id/eprint/88894

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