{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:56:20Z","timestamp":1770738980944,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007405","name":"Danish Heart Foundation","doi-asserted-by":"publisher","award":["14-R97-A5179-22868"],"award-info":[{"award-number":["14-R97-A5179-22868"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007405","name":"Danish Heart Foundation","doi-asserted-by":"publisher","award":["15-R99-A6034-22905"],"award-info":[{"award-number":["15-R99-A6034-22905"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Foundations at Rigshospitalet","award":["E-22329-01"],"award-info":[{"award-number":["E-22329-01"]}]},{"DOI":"10.13039\/501100001734","name":"University of Copenhagen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p\/>\n                  <jats:p>Brain dysfunction is a serious complication after cardiac surgery. In the Perfusion Pressure Cerebral Infarcts trial, we allocated cardiac surgery patients to a mean arterial pressure of either 70\u201380 or 40\u201350\u2009mmHg during cardiopulmonary bypass (CPB). In this secondary analysis, we compared selected cerebral metabolites using magnetic resonance spectroscopy hypothesizing that a postoperative decrease in occipital grey matter (GM) N-acetylaspartate-to-total-creatine ratio, indicative of ischaemic injury, would be found in the high-target group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Of the 197 patients randomized in the Perfusion Pressure Cerebral Infarcts trial, 55 and 42 patients had complete and useful data from GM and white matter (WM), respectively. Spectroscopies were done preoperatively and on postoperative days 3\u20136. Cognitive function was assessed prior to surgery, at discharge and at 3\u2009months. We predefined the statistical significance level to be 0.01.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A postoperative decrease was found in GM N-acetylaspartate-to-total-creatine ratio in the high-target group [mean difference \u22120.09 (95% confidence interval \u22120.14 to \u22120.04), P\u2009=\u20090.014]. No significant differences were found in other metabolite ratios investigated in GM or WM. No significant association was found between changes in metabolite ratios and new cerebral infarcts, WM lesion score or cognitive dysfunction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A higher mean arterial pressure during CPB was associated with signs of impaired cerebral metabolism, though not at the predefined significance level of 0.01. No significant association was found between metabolite ratio changes and neuroradiological pathology or change in cognitive function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration number<\/jats:title>\n                  <jats:p>Clinicaltrials.gov: NCT02185885.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa216","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T19:10:30Z","timestamp":1592248230000},"page":"1035-1044","source":"Crossref","is-referenced-by-count":3,"title":["Blood pressure and brain injury in cardiac surgery: a secondary analysis of a randomized trial"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-6630","authenticated-orcid":false,"given":"Anne G","family":"Vedel","sequence":"first","affiliation":[{"name":"D epartment of Cardiothoracic Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"},{"name":"D epartment of Anaesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Holmgaard","sequence":"additional","affiliation":[{"name":"D epartment of Cardiothoracic Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Else R","family":"Danielsen","sequence":"additional","affiliation":[{"name":"D epartment of Radiology, Diagnostic Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Langkilde","sequence":"additional","affiliation":[{"name":"D epartment of Radiology, Diagnostic Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7712-8596","authenticated-orcid":false,"given":"Olaf B","family":"Paulson","sequence":"additional","affiliation":[{"name":"Neurobiology Research Unit, Neuroscience Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4702-5195","authenticated-orcid":false,"given":"Hanne B","family":"Ravn","sequence":"additional","affiliation":[{"name":"D epartment of Cardiothoracic Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-3004","authenticated-orcid":false,"given":"Lars S","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"D epartment of Anaesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens C","family":"Nilsson","sequence":"additional","affiliation":[{"name":"D epartment of Cardiothoracic Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"2020102110254761000_ezaa216-B1","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/S0003-4975(01)02929-0","article-title":"Stroke after cardiac surgery: short- and long-term outcomes","volume":"72","author":"Salazar","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"2020102110254761000_ezaa216-B2","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1001\/jama.2011.37","article-title":"Temporal onset, risk factors and outcomes associated with stroke after 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