Department of Cardiac Surgery Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Jiangsu China.
Department of Cardiac Surgery Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Jiangsu China.
J Am Heart Assoc. 2024 Oct;13(19):e034351. doi: 10.1161/JAHA.124.034351. Epub 2024 Sep 18.
Type A aortic dissection presents challenges with postoperative cerebral complications, and this study evaluates the predictive value of quantitative electroencephalography for perioperative brain function prognosis.
Amplitude-integrated electroencephalography (aEEG) processes raw signals through filtering, amplitude integration, and time compression, displaying the data in a semilogarithmic format. Using this method, postoperative relative band power (post-RBP) α% and dynamic aEEG (ΔaEEG) grade were significantly associated with neurological dysfunction in univariate and multivariable analyses, with area under the receiver operating characteristic curve of 0.876 (95% CI, 0.825-0.926) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with adverse outcomes, with area under the receiver operating characteristic curve of 0.903 (95% CI, 0.835-0.971) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with transient neurological dysfunction and stroke, with areas under the receiver operating characteristic curve of 0.818 (95% CI, 0.760-0.876) and 0.868 (95% CI, 0.810-0.926) for transient neurological dysfunction, and 0.815 (95% CI, 0.743-0.886) and 0.831 (95% CI, 0.746-0.916) for stroke. Among 56 patients, the Alberta Stroke Program Early Computed Tomography score was superior to ΔaEEG in predicting neurological outcomes (area under the receiver operating characteristic curve of 0.872 versus 0.708 [95% CI, 0.633-0.783]; <0.05).
Perioperative quantitative electroencephalography monitoring offers valuable insights into brain function changes in patients with type A aortic dissection. ∆aEEG grades can aid in early detection of adverse outcomes, while postoperative relative band power and ∆aEEG grades predict transient neurological dysfunction. Quantitative electroencephalography can assist cardiac surgeons in assessing brain function and improving outcomes in patients with type A aortic dissection.
URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2200055980.
A型主动脉夹层术后存在脑并发症的挑战，本研究评估定量脑电图对围术期脑功能预后的预测价值。
振幅整合脑电图（aEEG）通过滤波、幅度整合和时间压缩对原始信号进行处理，以半对数格式显示数据。使用该方法，术后相对带宽功率（post-RBP）α%和动态 aEEG（ΔaEEG）分级在单变量和多变量分析中与神经功能障碍显著相关，联合模型的受试者工作特征曲线下面积为 0.876（95%CI，0.825-0.926）。术后相对带宽功率α%和ΔaEEG 与不良结局显著相关，联合模型的受试者工作特征曲线下面积为 0.903（95%CI，0.835-0.971）。术后相对带宽功率α%和ΔaEEG 与短暂性神经功能障碍和中风显著相关，受试者工作特征曲线下面积分别为 0.818（95%CI，0.760-0.876）和 0.868（95%CI，0.810-0.926）用于短暂性神经功能障碍，0.815（95%CI，0.743-0.886）和 0.831（95%CI，0.746-0.916）用于中风。在 56 例患者中，阿尔伯塔卒中计划早期计算机断层扫描评分在预测神经结局方面优于ΔaEEG（受试者工作特征曲线下面积为 0.872 与 0.708（95%CI，0.633-0.783）；<0.05）。
围手术期定量脑电图监测为 A 型主动脉夹层患者的脑功能变化提供了有价值的见解。∆aEEG 分级有助于早期发现不良结局，而术后相对带宽功率和∆aEEG 分级可预测短暂性神经功能障碍。定量脑电图有助于心脏外科医生评估 A 型主动脉夹层患者的脑功能并改善其结局。
