The Association of Brain MRI Characteristics and XXXX in Cardiac Surgery @entity1 .

@entity1 @entity2806 @entity73 @entity260 @entity194 @entity933 @entity62
PURPOSE: @entity933 is common after cardiac surgery and is associated with adverse consequences, including @entity73 . Identification of vulnerable older adults might allow for early implementation of @entity933 -prevention strategies. Brain MRI findings provide insight into structural brain changes that may identify vulnerable @entity1 . The purpose of this study was to examine the association between brain MRI characteristics potentially associated with @entity933 vulnerability and the development of @entity260 in a nested cohort of @entity1 undergoing cardiac surgery. METHODS: We identified 79 cardiac surgery @entity1 who had brain MRI imaging after cardiac surgery, as part of an ongoing randomized trial evaluating the efficacy of blood pressure management based on cerebral autoregulation monitoring versus standard management for improving neurological outcomes. Cerebral lateral ventricular size, cortical sulcal width, and @entity62 ( @entity62 ) on brain MRI scans were graded on a validated 0 to 9 scale, and categorized into tertiles. New @entity2806 were characterized as present or absent. @entity933 was assessed using a validated chart-review. Neuropsychological testing performed before surgery was used to establish preoperative cognitive baseline. Multivariable logistic regression was used to assess the independent association between MRI characteristics and @entity260 . FINDINGS: The average age of @entity1 was 70.1    7.8 years old, and 72% were male. Twenty-eight of 79 (35.4%) @entity1 developed @entity260 . @entity1 with @entity933 had higher unadjusted ventricular size (median 4 vs. 3, P = 0.003), and there was a trend towards higher sulcal sizes and @entity62 grades. Increasing tertiles of ventricular size (Odds Ratio [OR] 3.59; 95% Confidence Interval [CI] 1.59-8.12; P = 0.002) and sulcal size (OR 2.15; 95%CI 1.13-4.12; P = 0.02) were associated with @entity260 , with a trend for tertiles of @entity62 grade (OR 1.91; 95%CI 0.99-3.68; P = 0.05). In multivariable models adjusted for logistic EuroSCORE, baseline cognitive status, bypass time, and any @entity260 , each tertile of ventricular size was associated with increased odds of @entity260 (OR 3.23 per tertile increase in ventricular size; 95%CI 1.21-8.60; P = 0.02). There were no differences in odds of @entity933 by tertiles of sulcal grade, tertiles of white matter grade, or presence of new @entity2806 , in adjusted models. IMPLICATIONS: Increased brain ventricular size was independently associated with @entity933 after cardiac surgery. These results suggest that @entity194 may contribute to increased vulnerability for @entity260 . Baseline brain MRIs may be useful in identifying cardiac surgery @entity1 at high risk for @entity260 , who might benefit from targeted perioperative approaches to prevent @entity933 . ClinicalTrials.gov identifier: NCT00981474.
