Yao Yue, Shao Hongan, Masters Joe, Ji Muhuo, Yang Jing, Tian Jun, Sun Xu, Zhou Yi, Ren Yun, Zhang Zexin, Ma Daqing, Chen Jiu, Yao Hao
Department of Anaesthesiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Anaesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
Department of Thoracic Surgery, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Br J Anaesth. 2025 Feb;134(2):402-413. doi: 10.1016/j.bja.2024.10.022. Epub 2024 Dec 19.
Systemic inflammation after heart valve replacement surgery commonly results in complications including cognitive impairment. This study was designed to investigate whether valvular heart disease itself and inflammation after valve replacement surgery affects cognition and the related functional connectivity (FC) of the hippocampal memory network.
Forty-three patients with valvular heart disease were screened for recruitment and assessed with cognition function tests, blood inflammatory cytokine measurements, and functional magnetic resonance imaging scans before surgery and on postoperative day 7 and 30. Age- and sex-matched healthy controls (n=30) were recruited for comparison. The brain FC networks using the hippocampus as a seed were analysed. Bivariate correlation and structural equation model analyses were carried out to investigate the association between altered FC, memory, and inflammation.
Thirty-five patients and 29 healthy controls completed the study, and their data were finally analysed and reported. Compared with healthy controls, the surgery group had increased FC in the bilateral precuneus and middle cingulate and paracingulate gyri before surgery. They exhibited impaired memory, increased plasma concentrations of proinflammatory cytokines, and decreased hippocampal FC at postoperative day 7. At 30 days after surgery, the FC abnormalities seen before surgery and at postoperative day 7 were restored to the level comparable with the healthy controls. High systemic inflammation was significantly associated with worse memory and lower FC in the hippocampal memory network.
Valve replacement surgery temporarily disrupts the hippocampal memory network with transient associated memory decline.
ChiCTR2300069614.
心脏瓣膜置换术后的全身炎症通常会导致包括认知障碍在内的并发症。本研究旨在调查瓣膜性心脏病本身以及瓣膜置换术后的炎症是否会影响认知以及海马记忆网络的相关功能连接（FC）。
筛选43例瓣膜性心脏病患者进行招募，并在手术前、术后第7天和第30天进行认知功能测试、血液炎症细胞因子测量和功能磁共振成像扫描。招募年龄和性别匹配的健康对照者（n = 30）进行比较。分析以海马为种子的脑FC网络。进行双变量相关性和结构方程模型分析，以研究FC改变、记忆和炎症之间的关联。
35例患者和29例健康对照者完成了研究，最终对他们的数据进行了分析和报告。与健康对照者相比，手术组在手术前双侧楔前叶、中扣带回和旁扣带回的FC增加。他们在术后第7天表现出记忆受损、促炎细胞因子血浆浓度升高以及海马FC降低。术后30天，手术前和术后第7天出现的FC异常恢复到与健康对照者相当的水平。高全身炎症与较差的记忆和海马记忆网络中较低的FC显著相关。
瓣膜置换手术会暂时破坏海马记忆网络，并伴有短暂的相关记忆下降。
ChiCTR2300069614。
