Open AccessPrevalence of Cerebral Microbleeds in Patients With Continuous‐Flow Left Ventricular Assist Devices
Author(s) -
Yoshioka Daisuke,
Okazaki Shuhei,
Toda Koichi,
Murase Sho,
Saito Shunsuke,
Domae Keitaro,
Miyagawa Shigeru,
Yoshikawa Yasushi,
Daimon Takashi,
Sakaguchi Manabu,
Sawa Yoshiki
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.005955
Subject(s) - medicine , interquartile range , stroke (engine) , cardiology , ventricular assist device , confidence interval , incidence (geometry) , odds ratio , prospective cohort study , heart failure , mechanical engineering , physics , optics , engineering
Background The prevalence of cerebral microbleeds ( CMB s) in gradient echo T2*‐weighted brain MRI has a positive correlation with hemorrhagic stroke incidence. However, the prevalence of CMB s in patients with left ventricular assist devices ( LVADs ) has not been evaluated. We evaluated the prevalence of CMB s and the relationship with hemorrhagic stroke incidence in patients with LVADs. Method and Results We analyzed results from brain MRI in prospective examinations of 35 consecutive patients who had undergone LVAD explantation for heart transplantation or recovery since 2011. The number and distribution of CMB s were counted, then the relationship between baseline characteristics and adverse events during LVAD support were analyzed. The mean age was 37.7±12.4 years and the mean LVAD duration was 2.43±1.08 years. Thirty‐four (97%) patients had at least one CMB . Nine (26%) developed hemorrhagic stroke during LVAD support, and patients with hemorrhagic stroke had a significantly greater number of CMB s compared with patients without hemorrhagic stroke (5 [interquartile range ( IQR ), 4–7] versus 9 [ IQR , 5–23]; odds ratio 1.14 [95% Confidence Interval (CI), 1.02–1.32], P =0.05). There was no significant relationship between age, LVAD support duration, or systolic blood pressure during LVAD . However, patients who had at least one episode of bacteremia (9 [ IQR , 4–16] versus 5 [ IQR , 3–7], P =0.06) and pump pocket infection (14 [ IQR , 4–27] versus 5 [ IQR , 3–7], P =0.08) showed a trend toward a greater number of CMB s than patients without bacteremia. Conclusions Thirty‐four (97%) patients with continuous‐flow LVAD had at least one CMB , and the number of CMB s were more prevalent in patients with hemorrhagic stroke and in patients with LVAD ‐related infection.