BACKGROUND The potential impact of long-term left ventricular assist device (LVAD) support on the brain remains unclear. This study aimed to investigate cerebral microvascular damage in patients after long-term LVAD implantation using magnetic resonance imaging (MRI). METHODS We reviewed the medical records of patients after continuous-flow LVAD implantation in our hospital from 2006 to 2016, who underwent brain MRI after LVAD explantation for either transplantation or recovery. Age- and sex-matched healthy controls and patients with chronic heart failure (CHF) were collected from our pooled MRI database. The presence of cerebral microbleeds (CMBs) and cortical superficial siderosis and the severity of white matter hyperintensity (WMH) and cerebral atrophy were compared between patients with prior LVAD and 2 control groups. RESULTS This study included 49 patients with prior LVAD, 49 healthy controls, and 45 patients with CHF. CMBs and cortical superficial siderosis were detected in 98% (p < 0.001) and 31% (p < 0.001) of patients with prior LVAD, respectively. The number of CMBs was higher in patients with prior LVAD than in the 2 control groups. The severity of the WMH was higher in patients with prior LVAD than in healthy controls but similar to that in patients with CHF. Quantitative analyses of cerebral atrophy revealed a significantly higher bicaudate ratio and cella media index in patients with prior LVAD than in the 2 control groups. CONCLUSIONS Patients after long-term LVAD support showed a higher prevalence of CMBs and cortical superficial siderosis and more severe cerebral atrophy than did controls. These findings may indicate cerebral microvascular damages in long-term LVAD support patients.

中文翻译：

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移植后左心室辅助装置支持后患者的脑成像异常。

背景技术长期左心室辅助装置（LVAD）支持对大脑的潜在影响仍不清楚。这项研究旨在利用磁共振成像（MRI）研究长期LVAD植入后患者的脑微血管损伤。方法我们回顾性分析了我院2006年至2016年连续流LVAD植入后患者的病历，这些患者在LVAD植入后接受了脑部MRI检查以进行移植或恢复。年龄和性别匹配的健康对照者和慢性心力衰竭（CHF）患者均来自我们的MRI汇总数据库。比较既往LVAD患者和2个对照组的脑微出血（CMBs）和皮质浅表铁皮病的存在，以及白质高强度（WMH）和脑萎缩的严重程度。结果本研究包括49例既往患有LVAD的患者，49例健康对照和45例CHF的患者。分别有98％（p <0.001）和31％（p <0.001）既往LVAD患者中检测到CMBs和皮质浅表铁皮病。患有LVAD的患者的CMB数量高于2个对照组。LVAD患者中WMH的严重程度高于健康对照者，但与CHF患者相似。对脑萎缩症的定量分析显示，既往LVAD患者比2个对照组的双盲比率和细胞介质指数显着更高。结论长期接受LVAD支持的患者与对照组相比，CMB和皮层浅表铁皮病的患病率更高，脑萎缩更为严重。