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Braemswig TB, Kusserow M, Bellmann B, Beckhoff F, Reinthaler M, von Rennenberg R, Erdur H, Scheitz JF, Galinovic I, Villringer K, Leistner DM, Audebert HJ, Endres M, Landmesser U, Haeusler KG, Fiebach JB, Lauten A, Rillig A, Nolte CH. New Cerebral Microbleeds After Catheter-Based Structural Heart Interventions: An Exploratory Analysis. J Am Heart Assoc 2023; 12:e8189. [PMID: 36734351 PMCID: PMC9973666 DOI: 10.1161/jaha.122.027284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Cerebral microbleeds (CMBs) are increasingly recognized as "covert" brain lesions indicating increased risk of future neurological events. However, data on CMBs in patients undergoing catheter-based structural heart interventions are scarce. Therefore, we assessed occurrence and predictors of new CMBs in patients undergoing catheter-based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Methods and Results We conducted an exploratory analysis using data derived from 2 prospective, observational studies. Eligible patients underwent cerebral magnetic resonance imaging (3 Tesla) examinations and cognitive tests (using the Montreal Cognitive Assessment) before and after catheter-based left atrial appendage closure and percutaneous mitral valve repair. Forty-seven patients (53% men; median age, 77 years) were included. New CMBs occurred in 17 of 47 patients (36%) following catheter-based structural heart interventions. Occurrences of new CMBs did not differ significantly between patients undergoing catheter-based left atrial appendage closure and percutaneous mitral valve repair (7/25 versus 10/22; P=0.348). In univariable analysis, longer procedure time was significantly associated with new CMBs. Adjustment for heparin attenuated this association (adjusted odds ratio [per 30 minutes]: 1.77 [95% CI, 0.92-3.83]; P=0.090). Conclusions New CMBs occur in approximately one-third of patients after catheter-based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Our data suggest that longer duration of the procedure may be a risk factor for new CMBs. Future studies in larger populations are needed to further investigate their clinical relevance. Clinical Trial Registration German Clinical Trials Register: DRKS00010300 (https://drks.de/search/en/trial/DRKS00010300); ClinicalTrials.gov : NCT03104556 (https://clinicaltrials.gov/ct2/show/NCT03104556?term=NCT03104556&draw=2&rank=1).
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Affiliation(s)
- Tim Bastian Braemswig
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
| | - Madeleine Kusserow
- Klinik für Innere MedizinBundeswehrkrankenhaus BerlinBerlinGermany
- Charité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Barbara Bellmann
- MEDIAN Klinik AGZ DüsseldorfDüsseldorfGermany
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Frederik Beckhoff
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Markus Reinthaler
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Institute of Active Polymers and Berlin‐Brandenburg Center for Regenerative TherapiesHelmholtz‐Zentrum HereonTeltowGermany
- Deutsches Herzzentrum der Charité, Klinik für KardiologieAngiologie und IntensivmedizinBerlinGermany
| | - Regina von Rennenberg
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (DZNE), partner site BerlinBerlinGermany
| | - Hebun Erdur
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Jan F. Scheitz
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
| | - Ivana Galinovic
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Kersten Villringer
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - David M. Leistner
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Department of Medicine III, CardiologyGoethe UniversityFrankfurt am MainGermany
- German Centre for Cardiovascular Research (DZHK), partner site Rhine‐MainFrankfurtGermany
| | - Heinrich J. Audebert
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Matthias Endres
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (DZNE), partner site BerlinBerlinGermany
- ExcellenceCluster NeuroCureBerlinGermany
| | - Ulf Landmesser
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Deutsches Herzzentrum der Charité, Klinik für KardiologieAngiologie und IntensivmedizinBerlinGermany
| | | | - Jochen B. Fiebach
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Alexander Lauten
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Department of General and Interventional CardiologyHelios Klinikum ErfurtErfurtGermany
| | - Andreas Rillig
- Department of CardiologyCampus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Universitäres Herz‐ und Gefässzentrum Hamburg‐EppendorfHamburgGermany
| | - Christian H. Nolte
- Klinik und Hochschulambulanz für NeurologieCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin BerlinBerlinGermany
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (DZNE), partner site BerlinBerlinGermany
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Kusserow M, Spandl J. Alkoholyse von [Fe2(OtBu)6] als einfacher Weg zu neuen Eisen(III)-Alkoxo-Verbindungen: Synthesen und Kristallstrukturen von [Fe2(OtAmyl)6], [Fe5OCl(OiPr)12], [Fe5O(OiPr)13], [Fe5O(OiBu)13], [Fe5O(OCH2CF3)13], [Fe5O(OnPr)13] und [Fe9O3(OnPr)21] ·iPrOH. Z Anorg Allg Chem 2006. [DOI: 10.1002/zaac.200500474] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Spandl J, Kusserow M, Brüdgam I. Alkoxo-Verbindungen des dreiwertigen Eisen: Synthese und Charakterisierung von [Fe2(OtBu)6], [Fe2Cl2(OtBu)4], [Fe2Cl4(OtBu)2] und [N(nBu)4]2[Fe6OCl6(OMe)12]. Z Anorg Allg Chem 2003. [DOI: 10.1002/zaac.200300008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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