Heart valve procedure leaves hidden brain damage markers in blood
A common heart procedure used in elderly patients triggers detectable signs of brain cell injury, even when patients show no obvious neurological symptoms. The finding could lead to a simple blood test that identifies which patients suffer silent strokes during the procedure — potentially reshaping how doctors assess procedural risk and manage patient recovery.
Originaltitel: Plasma neurofilament light chain is elevated after transcatheter aortic valve implantation
<p><strong><em>Introduction:</em></strong> Transcatheter aortic valve implantation (TAVI) is associated with a high incidence of new silent brain infarcts (SBIs) on postprocedural neuroimaging. A venous blood sample reflecting neuronal damage following TAVI could help identify patients with potential SBIs. We aimed to investigate if a biochemical marker of neuronal injury, neurofilament light chain (NFL), is elevated after TAVI.</p><p><strong><em>Methods:</em></strong> In this observational study, NFL was measured in plasma from 31 patients before and after TAVI. Multivariable regression analysis was performed to investigate any effect of clinical- and procedure-related factors on differences in NFL levels before and after TAVI. <strong><em></em></strong></p><p><strong><em>Results:</em></strong> Samples were collected 41 (14–81) days before and 44 (35–59) days after TAVI, median (interquartile range). Median age was 81 (77–84) years, and 35% were female. No patient had any overt procedure-related neurological complications. The geometric mean (95% confidence interval) of the NFL concentration was 30 (25–36) pg/mL before TAVI and 48 (39–61) pg/mL, after TAVI, <em>p</em> <0.001. None of the included variables in the multiple linear regression model were statistically significantly associated with the difference in levels before and after TAVI.</p><p><strong><em>Conclusions:</em></strong> NFL levels in plasma were higher after TAVI as compared with levels before, with a mean increase of 60% (18 pg/mL). Further studies including neuroimaging and cognitive outcomes are needed to understand the potential value of measuring NFL in relation to TAVI.</p>