Silent cerebral infarcts associated with cardiac disease and procedures

KEY POINTS * Silent cerebral infarcts (SCIs) are increasingly observed in patients with cardiac disease and in individuals who have undergone invasive cardiac procedures * Cardiac diseases

associated with the occurrence of SCIs include atrial fibrillation, cardiomyopathies, and atrial septal abnormalities * Postprocedural SCIs have been detected using MRI after left cardiac

catheterization, transcatheter aortic valve implantation, CABG surgery, pulmonary vein isolation, and closure of patent foramen ovale * SCIs do not always result in acute symptoms, but have

been associated with a threefold increase in the risk of stroke, and can be considered a precursor of ischaemic stroke * Accumulating evidence suggests that SCIs might have a role in the

development of dementia and depression, and in cognitive decline * Increased recognition of SCIs could advance our understanding of their links to cardiac and neurological disorders, and

facilitate the development of preventative therapeutic approaches ABSTRACT The occurrence of clinically silent cerebral infarcts (SCIs) in individuals affected by cardiac disease and after

invasive cardiac procedures is frequently reported. Indeed, atrial fibrillation, left ventricular thrombus formation, cardiomyopathy, and patent foramen ovale have all been associated with

SCIs. Furthermore, postprocedural SCIs have been observed after left cardiac catheterization, transcatheter aortic valve implantation, CABG surgery, pulmonary vein isolation, and closure of

patent foramen ovale. Such SCIs are often described as precursors to symptomatic stroke and are associated with cognitive decline, dementia, and depression. Increased recognition of SCIs

might advance our understanding of their relationship with heart disease and invasive cardiac procedures, facilitate further improvement of therapies or techniques aimed at preventing their

occurrence and, therefore, decrease the risk of adverse neurological outcomes. In this Review, we provide an overview of the occurrence and clinical significance of, and the available

diagnostic modalities for, SCIs related to cardiac disease and associated invasive cardiac procedures. Access through your institution Buy or subscribe This is a preview of subscription

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Scholar  Download references ACKNOWLEDGEMENTS This work was supported by grants from the Dutch Heart Foundation (2011 T022) and National Health Insurance Board/ZonMw, Netherlands

(40-00703-98-11629) to R. Delewi. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105

AZ, Netherlands Mariëlla E. C. Hassell, Jan J. Piek & Ronak Delewi * Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ,

Netherlands Yvo B. W. Roos * Department of Neuroradiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands Charles B. L. Majoie * Department

of Cardiology, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, Netherlands Robin Nijveldt * Clinical Research Department, University Hospital of Caen, Avenue

Côte de Nacre, Caen, Normandy, France Martial Hamon Authors * Mariëlla E. C. Hassell View author publications You can also search for this author inPubMed Google Scholar * Robin Nijveldt

View author publications You can also search for this author inPubMed Google Scholar * Yvo B. W. Roos View author publications You can also search for this author inPubMed Google Scholar *

Charles B. L. Majoie View author publications You can also search for this author inPubMed Google Scholar * Martial Hamon View author publications You can also search for this author

inPubMed Google Scholar * Jan J. Piek View author publications You can also search for this author inPubMed Google Scholar * Ronak Delewi View author publications You can also search for

this author inPubMed Google Scholar CONTRIBUTIONS M. E. C. Hassell researched the data for the article. M. E. C. Hassell, R. Delewi, and R. Nijveldt contributed substantially to discussion

of the content. M. E. C. Hassell and R. Delewi contributed substantially to writing the article. All the authors reviewed/edited the manuscript before submission. CORRESPONDING AUTHOR

Correspondence to Ronak Delewi. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing financial interests. POWERPOINT SLIDES POWERPOINT SLIDE FOR FIG. 1 POWERPOINT SLIDE

FOR FIG. 2 POWERPOINT SLIDE FOR TABLE 1 POWERPOINT SLIDE FOR TABLE 2 RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hassell, M., Nijveldt, R., Roos, Y.

_et al._ Silent cerebral infarcts associated with cardiac disease and procedures. _Nat Rev Cardiol_ 10, 696–706 (2013). https://doi.org/10.1038/nrcardio.2013.162 Download citation *

Published: 29 October 2013 * Issue Date: December 2013 * DOI: https://doi.org/10.1038/nrcardio.2013.162 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

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