Clinical Significance of Diffusion-Weighted Brain MRI Lesions After TAVR: Results of a Patient-Level Pooled Analysis.
Alexandra J LanskyDaniel GrubmanMichael G DwyerRobert ZivadinovHelen PariseJeffrey W MosesTayyab ShahCody PietrasDaniela TirziuLouise GamboneMartin B LeonTamim M NazifSteven R MesséPublished in: Journal of the American College of Cardiology (2024)
Our study confirms that the number, size, and total volume of acute brain infarction defined by DW-MRI are each associated with clinical ischemic strokes, disabling strokes, and worse stroke recovery in patients undergoing TAVR and may have value as surrogate outcomes in stroke prevention trials. (A Prospective, Randomized Evaluation of the TriGuard™ HDH Embolic Deflection Device During TAVI [DEFLECT III]; NCT02070731) (A Study to Evaluate the Neuro-embolic Consequences of TAVR [NeuroTAVR]; NCT02073864) (The REFLECT Trial: Cerebral Protection to Reduce Cerebral Embolic Lesions After Transcatheter Aortic Valve Implantation [REFLECT I]; NCT02536196) (The REFLECT Trial: Cerebral Protection to Reduce Cerebral Embolic Lesions After Transcatheter Aortic Valve Implantation [REFLECT II]; NCT02536196).
Keyphrases
- transcatheter aortic valve implantation
- aortic valve
- aortic stenosis
- cerebral ischemia
- transcatheter aortic valve replacement
- aortic valve replacement
- subarachnoid hemorrhage
- contrast enhanced
- ejection fraction
- diffusion weighted
- left ventricular
- brain injury
- magnetic resonance imaging
- patients undergoing
- study protocol
- atrial fibrillation
- blood brain barrier
- phase ii
- clinical trial
- phase iii
- white matter
- randomized controlled trial
- magnetic resonance
- metabolic syndrome
- computed tomography
- liver failure
- type diabetes
- cerebral blood flow
- hepatitis b virus
- heart failure
- drug induced
- multiple sclerosis
- case report
- acute respiratory distress syndrome
- insulin resistance