Microemboli in Cerebral Circulation and Alteration of Cognitive Abilities in Patients With Mechanical Prosthetic Heart Valves
| Autor: | Corinne Gautier, Jean-Louis Lecroart, Martine F. Roussel, Alain Prat, Ghislaine Deklunder |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Ultrasonography Doppler Transcranial medicine.medical_treatment Neuropsychological Tests Prosthesis Random Allocation Cerebral circulation medicine Humans Attention Heart valve Stroke Aged Advanced and Specialized Nursing business.industry Extracorporeal circulation Cognition Intracranial Embolism and Thrombosis Middle Aged medicine.disease Transcranial Doppler Cognitive test Memory Short-Term medicine.anatomical_structure Heart Valve Prosthesis Anesthesia Mental Recall Female Neurology (clinical) Cognition Disorders Cardiology and Cardiovascular Medicine business |
| Zdroj: | Stroke. 29:1821-1826 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.29.9.1821 |
| Popis: | Background and Purpose —It has been shown previously that cerebral microemboli may occur frequently in patients with a normal mechanical heart valve (MHV) without prior history of stroke. Some arguments strongly suggest that these microemboli have a gaseous origin. In other circumstances such as extracorporeal circulation or decompression in divers, it has been demonstrated that cerebral microbubbles could lead to some deterioration in cognitive functions. Therefore, we have studied attention and memory, which are among the most impaired cognitive functions as demonstrated in previous studies, in patients with an MHV. Methods —Three groups of 12 volunteers each were composed of patients with an MHV and embolic signals in the cerebral circulation (group 1), patients with biological prostheses (group 2), and healthy subjects (group 3). Groups were carefully matched for age and verbal intellectual abilities. For each group, a transcranial Doppler examination was performed and a set of cognitive tests assessing sustained and selective attention and episodic and working memory was administered. Results —The mean embolic rate was 29 per hour in patients with an MHV. No embolus was detected in the other 2 groups. Episodic memory was significantly modified in both groups 1 and 2 compared with the control group for tasks that required high-processing resources. Working memory performance was significantly decreased in MHV patients. No between-groups differences were observed for the other parameters. Conclusions —Alteration of episodic memory can be attributed to a long-term effect of the surgical procedure. Deterioration of working memory can be related to the presence of cerebral microemboli in MHV patients. |
| Databáze: | OpenAIRE |
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