title: Silent cerebral infarcts associated with cardiac disease and procedures.
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.
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
authors.forename: Mariëlla E C
authors.initials: ME
authors.lastname: Hassell
authors.forename: Robin
authors.initials: R
authors.lastname: Nijveldt
authors.forename: Yvo B W
authors.initials: YB
authors.lastname: Roos
authors.forename: Charles B L
authors.initials: CB
authors.lastname: Majoie
authors.forename: Martial
authors.initials: M
authors.lastname: Hamon
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Ronak
authors.initials: R
authors.lastname: Delewi
mesh_terms: D058070:Asymptomatic Diseases; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology; D015140:Dementia, Vascular / Q000209:etiology; D003863:Depression / Q000209:etiology; D003952:Diagnostic Imaging; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D011237:Predictive Value of Tests; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome