INTRODUCTION 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. METHODS 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. RESULTS 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, p <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. CONCLUSIONS 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.

中文翻译：

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经导管主动脉瓣植入后血浆神经丝轻链升高。

简介 经导管主动脉瓣植入 (TAVI) 与术后神经影像学中新发无症状脑梗塞 (SBI) 的高发生率相关。反映 TAVI 后神经元损伤的静脉血样本可以帮助识别潜在 SBI 的患者。我们的目的是调查 TAVI 后神经元损伤的生化标志物神经丝轻链 (NFL) 是否升高。方法 在这项观察性研究中，对 TAVI 前后 31 名患者的血浆中的 NFL 进行了测量。进行多变量回归分析以研究临床和手术相关因素对 TAVI 前后 NFL 水平差异的影响。结果 样本采集时间为 TAVI 前 41 (14-81) 天和 TAVI 后 44 (35-59) 天，中位数（四分位距）。中位年龄为 81 (77-84) 岁，其中 35% 为女性。没有患者出现任何明显的与手术相关的神经系统并发症。TAVI 前 NFL 浓度的几何平均值（95% 置信区间）为 30 (25-36) pg/mL，TAVI 后为 48 (39-61) pg/mL，p <0.001。多元线性回归模型中的所有变量均与 TAVI 前后的水平差异没有统计学显着相关性。结论 TAVI 后血浆中 NFL 水平较之前升高，平均增加 60% (18 pg/mL)。需要进一步的研究，包括神经影像学和认知结果，以了解测量 NFL 与 TAVI 相关的潜在价值。