BACKGROUND: Data regarding the mid- to long-term cognitive trajectory of transcatheter aortic valve (TAVR) recipients are scarce. OBJECTIVES: Changes in global cognition and specific cognitive domains up to 1 year post-TAVR were evaluated. METHODS: Fifty-one patients (median age 80.0 [interquartile range: 72.0 to 85.0] years; 37% women) underwent TAVR and prospective assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) at baseline, short-term (30 days), and 1 year post-TAVR. Processing speed and executive cognitive functions were further evaluated with the digit-symbol substitution test (DSST), Trail Making Tests (TMT), and verbal fluency tests at the same time points. Cognitive decline (CD) was determined by changes in mean scores and as a rate using practice-corrected reliable change index (RCI). RESULTS: The baseline mean total MoCA score was 22.71 ± 3.84. Twenty patients (39.2%) were considered cognitively impaired using a cutoff of <23 of 30 points. Mean total MoCA score improved at short-term post-TAVR and remained stable at 1 year (p = 0.022). On the basis of the RCI of total MoCA score, 4 patients (7.8%) presented with short-term CD, which persisted at 1 year in 1 patient (2.0%). Four patients (7.8%) exhibited cognitive improvement at 1 year, increasing to 15% among those with baseline cognitive impairment. No significant changes were observed over time in the mean DSST, TMT, and verbal fluency test scores. On the basis of the RCI, 10 of 40 patients (25%) presented with a reduction in performance of at least 1 test at 30 days that persisted at 1 year in 4 patients (10%). CONCLUSIONS: TAVR was associated with global improvement in cognitive status, more pronounced among those with cognitive impairment pre-TAVR. However, early decline in some complex cognitive functions was observed in one-quarter of TAVR recipients, persisting at 1 year in 10% of patients.
BACKGROUND: Data regarding the mid- to long-term cognitive trajectory of transcatheter aortic valve (TAVR) recipients are scarce. OBJECTIVES: Changes in global cognition and specific cognitive domains up to 1 year post-TAVR were evaluated. METHODS: Fifty-one patients (median age 80.0 [interquartile range: 72.0 to 85.0] years; 37% women) underwent TAVR and prospective assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) at baseline, short-term (30 days), and 1 year post-TAVR. Processing speed and executive cognitive functions were further evaluated with the digit-symbol substitution test (DSST), Trail Making Tests (TMT), and verbal fluency tests at the same time points. Cognitive decline (CD) was determined by changes in mean scores and as a rate using practice-corrected reliable change index (RCI). RESULTS: The baseline mean total MoCA score was 22.71 ± 3.84. Twenty patients (39.2%) were considered cognitively impaired using a cutoff of <23 of 30 points. Mean total MoCA score improved at short-term post-TAVR and remained stable at 1 year (p = 0.022). On the basis of the RCI of total MoCA score, 4 patients (7.8%) presented with short-term CD, which persisted at 1 year in 1 patient (2.0%). Four patients (7.8%) exhibited cognitive improvement at 1 year, increasing to 15% among those with baseline cognitive impairment. No significant changes were observed over time in the mean DSST, TMT, and verbal fluency test scores. On the basis of the RCI, 10 of 40 patients (25%) presented with a reduction in performance of at least 1 test at 30 days that persisted at 1 year in 4 patients (10%). CONCLUSIONS: TAVR was associated with global improvement in cognitive status, more pronounced among those with cognitive impairment pre-TAVR. However, early decline in some complex cognitive functions was observed in one-quarter of TAVR recipients, persisting at 1 year in 10% of patients.
Authors: Miles Berger; Niccolò Terrando; S Kendall Smith; Jeffrey N Browndyke; Mark F Newman; Joseph P Mathew Journal: Anesthesiology Date: 2018-10 Impact factor: 7.892
Authors: Pál Maurovich-Horvat; Béla Merkely; Andrea Varga; Gyula Gyebnár; Ferenc Imre Suhai; Anikó Ilona Nagy; Lajos Rudolf Kozák; Csenge Ágnes Póka; Mirjam Franciska Turáni; Sarolta Borzsák; Astrid Apor; Andrea Bartykowszki; Bálint Szilveszter; Márton Kolossváry Journal: Neuroradiology Date: 2022-08-01 Impact factor: 2.995
Authors: Paul Toon Lim Chiam; Nien Shen Chan; Yean Teng Lim; Choon Pin Lim; Dinesh Nair; Tai Tian Lim; Chao Yang Soon; Brian Chung Hoe Khoo; Jimmy Lim; Kok Soon Tan; Leslie Lam; Peter Yan; Yau Wei Ooi; Mei Sian Chong Journal: Singapore Med J Date: 2022-02-24 Impact factor: 3.331
Authors: Annabelle Santos Volgman; C Noel Bairey Merz; Neelum T Aggarwal; Vera Bittner; T Jared Bunch; Philip B Gorelick; Pauline Maki; Hena N Patel; Athena Poppas; Jeremy Ruskin; Andrea M Russo; Shari R Waldstein; Nanette K Wenger; Kristine Yaffe; Carl J Pepine Journal: J Am Heart Assoc Date: 2019-09-24 Impact factor: 5.501
Authors: Nicholas Aroney; Tiffany Patterson; Christopher Allen; Simon Redwood; Bernard Prendergast Journal: J Clin Med Date: 2021-04-20 Impact factor: 4.241