{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:25:37Z","timestamp":1793381137196,"version":"4.5.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Left atrial appendage occlusion (LAAO) was associated with a high incidence of procedure\u2010related silent cerebral embolism (SCE). There are limited data regarding the long\u2010term cognitive trajectory of patients undergoing LAAO. The aim of our study was to comprehensively assess the acute and long\u2010term impact of SCE during and after LAAO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Consecutive patients with atrial fibrillation referred for LAAO from the First Affiliated Hospital with Nanjing Medical University between February 2021 and February 2023 were included. All patients underwent magnetic resonance imaging and cognitive assessments before and within 48 hours after the procedure. These evaluations were also repeated at 45\u2010day, 3\u2010month, 6\u2010month, and 1\u2010year follow up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Out of 75 patients included in the final analysis, 29 (38.7%) patients suffered from new SCE during LAAO. Patients with SCE exhibited a significant decline in cognitive function (Mini\u2010Mental State Examination) immediately after the procedure (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), which was not reversible during 1\u2010year follow\u2010up (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Additionally, with time going on, the gap in cognitive function between patients with and without SCE became wider (SCE\u2009\u00d7\u20091 year: B=\u22124.81 [95% CI, \u22125.58 to \u22124.05];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). New\u2010onset SCE was detected in 11 (14.7%) patients during the follow\u2010up magnetic resonance imaging, which also showed a decline in cognitive function (\n              <jats:italic>P<\/jats:italic>\n              =0.004). The results in Montreal Cognitive Assessment scores were consistent with Mini\u2010Mental State Examination.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LAAO\u2010related SCE is associated with a marked impairment in cognitive function immediately after the procedure and is irreversible over a 1\u2010year follow\u2010up. New magnetic resonance\u2010detected SCE during follow\u2010up after LAAO would also be associated with a decline in cognitive function.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.037968","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T10:16:21Z","timestamp":1738577781000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long\u2010Term Cognitive Function"],"prefix":"10.1161","volume":"14","author":[{"given":"Kexin","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-4088","authenticated-orcid":false,"given":"Zhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Hospital 2 of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyi","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4437-8930","authenticated-orcid":false,"given":"Mingjia","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfang","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4867-5341","authenticated-orcid":false,"given":"Hailei","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4276-2401","authenticated-orcid":false,"given":"Zidun","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwu","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing 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