Document Detail


Solid cerebral microemboli and cerebrovascular symptoms in patients with prosthetic heart valves.
MedLine Citation:
PMID:  18292387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Although cerebral microemboli are often detected by transcranial Doppler ultrasonography in mechanical heart valve patients, the clinical significance of such microemboli is unclear. The aim of this study was to determine the frequency and composition of cerebral microemboli in a prosthetic heart valve population and to correlate these findings to cerebrovascular symptoms, blood inflammation, and coagulation parameters. METHODS: Seventy-six consecutive patients with a total of 81 prosthetic (54 mechanical, 27 biologic) heart valves were monitored for cerebral microemboli by multifrequency transcranial Doppler ultrasonography 1 year after valve replacement. Cerebrovascular events in the first year were recorded by a neurologist. Inflammation and coagulation markers were measured by immunoassays. RESULTS: Microemboli were detected in mechanical heart valve patients only (28 patients, 56%). Twelve percent were solid, occurring in 17 (34%) of the mechanical heart valve population. The presence of solid cerebral microemboli was the only variable that was associated with cerebrovascular symptoms after a final regression analysis (P=0.026). The plasma monocyte chemotactic protein-1 level was raised in patients with solid microemboli (P=0.014). CONCLUSIONS: Solid cerebral microemboli were detected by multifrequency transcranial Doppler ultrasonography in 35% of a mechanical heart valve population, and the frequency was higher in patients who experienced cerebrovascular events during the first year after valve replacement. The results suggest that the detection of solid cerebral microemboli may be helpful in predicting the risk of ischemic stroke in mechanical heart valve patients.
Authors:
Mona Skjelland; Annika Michelsen; Frank Brosstad; Jan L Svennevig; Rainer Brucher; David Russell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-21
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-25     Completed Date:  2008-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1159-64     Citation Subset:  IM    
Affiliation:
Department of Neurology, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Oslo, Norway. mona.skjelland@rikshospitalet.no
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Amaurosis Fugax / epidemiology,  ultrasonography
Blood Coagulation
Embolism, Air / epidemiology,  ultrasonography
Female
Heart Valve Prosthesis / adverse effects*
Humans
Incidence
Inflammation / epidemiology
Intracranial Embolism / epidemiology*,  ultrasonography*
Ischemic Attack, Transient / epidemiology,  ultrasonography
Male
Middle Aged
Platelet Activation
Predictive Value of Tests
Risk Factors
Stroke / epidemiology*,  ultrasonography*
Ultrasonography, Doppler, Transcranial*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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