Anemia and risk of periprocedural cerebral injury detected by diffusion-weighted magnetic resonance imaging in patients undergoing transcatheter aortic valve replacement  

作　　者：Stella Ng Qi-feng Zhu Ju-bo Jiang Chun-hui Liu Jia-qi Fan Ye-ming Xu Xian-bao Liu Jian-an Wang 

机构地区：[1]Department of Cardiology,the Second Affi liated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China [2]Zhejiang University School of Medicine,Hangzhou 310058,China

出　　处：《World Journal of Emergency Medicine》2022年第1期32-39,共8页世界急诊医学杂志（英文）

基　　金：funded by Zhejiang Province Science and Technology Department Key R&D Program(2018C03084,2021C03097).

摘　　要：BACKGROUND: Anemia is prevalent in patients undergoing transcatheter aortic valve replacement(TAVR) and has been linked to impaired outcomes after the procedure. Few studies have evaluated the impact of anemia and new ischemic lesions post TAVR.METHODS: We prospectively enrolled 158 patients who received TAVR in our center. Anemia was defined according to the World Health Organization criteria as hemoglobin <12 g/dL in women and <13 g/dL in men. All patients underwent diffusion-weighted magnetic resonance imaging(DW-MRI) procedure before and within 4–7 days after TAVR. RESULTS: Anemia was present in 85(53.8%) patients who underwent TAVR, and 126(79.7%) patients had 718 new DW-MRI positive lesions with a mean of 4.54±5.26 lesions per patient. The incidence of new ischemic lesions was 81.2% in patients with anemia versus 78.1% in patients without anemia(P=0.629). Moreover, anemic patients had bigger total volume/lesions in the anterior cerebral artery/middle cerebral artery(ACA/MCA) and MCA regions compared to the non-anemic patients(31.89±55.78 mm^(3) vs. 17.08±37.39 mm^(3), P=0.049;and 54.54±74.72 mm^(3) vs. 33.75±46.03 mm^(3), P=0.034). Anemia was independently associated with the volume/lesion in the ACA/MCA(β=16.796, 95% confidence interval [95% CI] 2.001 to 31.591, P=0.026) and in the MCA zone(β=0.020, 95% CI 0.001 to 0.040, P=0.041). CONCLUSIONS: Patients with pre-procedural anemia may have bigger total volume/lesions in the ACA/MCA and MCA regions compared to the non-anemic patients. Whether the consequences of bigger total volume/lesions impact neurological and cognitive outcomes remains to be investigated.

关 键 词：Aortic stenosis ANEMIA Cerebral ischemic lesions Transcatheter aortic valve replacement 

分 类 号：R654.2[医药卫生—外科学] R445.2[医药卫生—临床医学]