Nübel Jonathan, Hauptmann Michael, Schön Julika, Fritz Georg, Butter Christian, Haase-Fielitz Anja
Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau, Germany.
Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
J Geriatr Cardiol. 2023 Sep 28;20(9):664-672. doi: 10.26599/1671-5411.2023.09.004.
Transfemoral aortic valve replacement (TAVR) is the standard treatment for elderly patients with aortic valve stenosis. Although safe and well-established, there is a risk of intraprocedural hemodynamic instability and silent cerebral embolism, which can lead to a decline in neurocognitive function and dementia. In clinical practice, comprehensive cognitive testing is difficult to perform. AI-assisted digital applications may help to optimize diagnosis and monitoring.
Neurocognitive function was assessed by validated psychometric tests using "∆elta -App", which uses artificial intelligence and computational linguistic methods for extraction and analysis. Memory function was assessed using the 'Consortium to Establish a Registry for Alzheimer's Disease' (CERAD) word list and digit span task (DST) before TAVR and before hospital discharge. The study is registered in the German Register of Clinical Trials (https://drks.de/search/de/trial/DRKS00020813).
From October 2020 until March 2022, 141 patients were enrolled at University Hospital Heart Centre Brandenburg. Mean age was 81 ± 6 years, 42.6% were women. Time between the pre- and post-interventional test was on average 6 ± 3 days. Memory function before TAVR was found to be below average in relation to age and educational level. The pre-post TAVR comparison showed significant improvements in the wordlist repeat, < 0.001 and wordlist recall test of CERAD, < 0.001. There were no changes in the digital span test.
Despite impaired preoperative memory function before TAVR, no global negative effect on memory function after TVAR was detected. The improvements shown in the word list test should be interpreted as usual learning effects in this task.
经股动脉主动脉瓣置换术（TAVR）是老年主动脉瓣狭窄患者的标准治疗方法。尽管该手术安全且成熟，但术中存在血流动力学不稳定和无症状性脑栓塞的风险，这可能导致神经认知功能下降和痴呆。在临床实践中，全面的认知测试难以实施。人工智能辅助数字应用可能有助于优化诊断和监测。
使用“∆elta -App”通过经过验证的心理测量测试评估神经认知功能，该应用使用人工智能和计算语言方法进行提取和分析。在TAVR术前和出院前，使用“阿尔茨海默病注册协会”（CERAD）单词列表和数字广度任务（DST）评估记忆功能。该研究已在德国临床试验注册中心注册（https://drks.de/search/de/trial/DRKS00020813）。
从2020年10月到2022年3月，141名患者在勃兰登堡大学医院心脏中心入组。平均年龄为81±6岁，42.6%为女性。介入前后测试之间的时间平均为6±3天。发现TAVR术前的记忆功能相对于年龄和教育水平低于平均水平。TAVR术前与术后比较显示，CERAD单词列表重复测试（<0.001）和单词列表回忆测试（<
