Cardiac surgery with valve replacement temporarily disrupts the hippocampal memory network

作者：Yue Yao, Hongan Shao, Joe Masters, Mu‐Huo Ji, Jing Yang, Jun Tian, Xu Sun, Yi Zhou, Yun Ren, Zexin Zhang, Daqing Ma, Jiu Chen, Hao Yao · 发表于：British Journal of Anaesthesia · 年份：2024 · DOI：10.1016/j.bja.2024.10.022 · 被引用次数：11 · 研究领域：Cardiac and Coronary Surgery Techniques、Cardiac Health and Mental Health、Intensive Care Unit Cognitive Disorders

BACKGROUND: 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. METHODS: 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. RESULTS: 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 th...